Organization
MLR MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSVALDO GONZALEZ (PRESIDENT)
(813) 443-2191
Entity
Organization
Contact information
Practice address
1936 W DR MARTIN L KING BLVD SUITE 209, TAMPA, FL 33607
(813) 443-2191
(813) 443-4823
Mailing address
1936 W DR MARTIN L KING BLVD SUITE 209, TAMPA, FL 33607
(813) 443-2191
(813) 443-4823
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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