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Organization

MEDI CLINICS PRIMARY CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VENKATA JAYA PRATAP BIREDDY M.D (OWNER/ADMINISTRATOR)
(813) 465-9999
Entity
Organization

Contact information

Practice address
502 S MACDILL AVE, TAMPA, FL 33609-3039
(813) 465-9999
(813) 831-6292
Mailing address
502 S MACDILL AVE, TAMPA, FL 33609-3039
(813) 465-9999
(813) 877-1222

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
261QM1300X
Multi-Specialty Clinic/Center
Primary
261QP2300X
Primary Care Clinic/Center

Other

Enumeration date
10/30/2012
Last updated
01/19/2024
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