Provider Type Icon

RAG MEDICAL CLINIC LLC NPI 1528624053


NPI Information

NPI: 1528624053
Provider Name: RAG MEDICAL CLINIC LLC

Doing Business As: PHOENIX MEDICAL CLINIC

Classification: Internal Medicine - 207RA0401X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 10D2170099

Address:
6408 N ARMENIA AVE STE B-1
TAMPA, FL
ZIP 33604
Phone: (813) 352-8305
Get Directions

RAG MEDICAL CLINIC LLC is an addiction medicine internal medicine in Tampa, FL. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. RAG MEDICAL CLINIC LLC NPI is 1528624053. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Phoenix Medical Clinic.

The provider's business location address is:

6408 N ARMENIA AVE STE B-1
TAMPA, FL
ZIP 33604-770
Phone: (813) 352-8305

The provider's authorized official is Ricardo A Gomez Fernandez .
The authorized official title is Administrator and has the following contact phone number (813) 352-8305.

The CLIA number assigned to this NPI record is 10D2170099 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/9/2019 and was last updated on 10/16/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineNo
3208D00000XGeneral PracticeNo
4207RA0401XInternal MedicineAddiction MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.