Organization
MLK MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSVALDO GONZALEZ (OWNER)
18134432191
Entity
Organization
Contact information
Practice address
1936 W DR MARTIN LUTHER KING JR BLVD STE 209, TAMPA, FL 33607-6530
(813) 443-2191
(813) 443-4823
Mailing address
1936 W DR MARTIN LUTHER KING JR BLVD STE 209, TAMPA, FL 33607-6530
(813) 443-2191
(813) 443-4823
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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