Organization
UNIVERSAL FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ORISMELCY DE LOS REYES PUPO APRN (APRN)
(813) 999-1103
Entity
Organization
Contact information
Practice address
5352 N HABANA AVE STE D, TAMPA, FL 33614-6838
(813) 999-1103
(813) 999-1373
Mailing address
5352 N HABANA AVE STE D, TAMPA, FL 33614-6838
(813) 999-1103
(813) 999-1373
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
06/13/2024
Last updated
01/08/2025
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