Organization
SOUTH CARE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEJANDRO GONZALEZ (OWNER)
(813) 770-7169
Entity
Organization
Contact information
Practice address
6822 W WATERS AVE, TAMPA, FL 33634
(813) 969-1700
Mailing address
4522 W VILLAGE DR STE 202, TAMPA, FL 33624-3429
(813) 969-1700
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
05/29/2019
Last updated
05/29/2019
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