Organization
SUNCOAST COMMUNITY HEALTH CENTERS, INC
Active
Other names
Thonotosassa Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT R RODRIGUEZ (CFO)
(813) 349-7563
Entity
Organization
Contact information
Practice address
9555 E FOWLER AVE, THONOTOSASSA, FL 33592-2139
(813) 653-6100
Mailing address
13110 ELK MOUNTAIN DR, RIVERVIEW, FL 33579-7182
(813) 349-7588
(813) 349-7596
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9999
NA
—
Enumeration date
05/19/2017
Last updated
06/11/2019
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