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Organization

FLORIDA FAMILY PRACTICE & URGENT CARE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RONALD SALAZAR MANALO M.D. (PRESIDENT)
(615) 838-5198
Entity
Organization

Contact information

Practice address
3450 E FLETCHER AVE STE 100, TAMPA, FL 33613-4603
(813) 812-4133
(813) 501-3633
Mailing address
3450 E FLETCHER AVE STE 100, TAMPA, FL 33613-4603
(813) 812-4133
(813) 501-3633

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019212900
FL
Enumeration date
09/08/2016
Last updated
03/11/2019
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