10D1064252 CLIA NUMBER - QUERUBIN P MENDOZA MD PA

Laboratory Demographics

CLIA Number: 10D1064252

Facility Name: QUERUBIN P MENDOZA MD PA

Facility Address:
5101 N HABANA AVE
TAMPA, FL
ZIP 33614
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Facility Phone Number: 813 248-2700

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1568458149

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	10D1064252
LAB Type	Physician Office
Facility Name	QUERUBIN P MENDOZA MD PA
Street	5101 N HABANA AVE
City	TAMPA
State	FL
ZIP	33614
Phone	813 248-2700
CertificateType	4
CertificateEffectiveDate	2/1/2023
CertificateExpirationDate	1/31/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024