Organization
IDEAL MEDICAL CENTER OF TAMPA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAMILE PUPO (OWNER)
(813) 609-3983
Entity
Organization
Contact information
Practice address
6821 W HILLSBOROUGH AVE, UNIT 10-11, TAMPA, FL 33634-5003
(813) 609-3983
Mailing address
6821 W HILLSBOROUGH AVE, UNIT 10-11, TAMPA, FL 33634-5003
(813) 609-3983
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/16/2014
Last updated
03/13/2017
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