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NODAL MEDICAL CENTER LLC NPI 1114457272


NPI Information

NPI: 1114457272
Provider Name: NODAL MEDICAL CENTER LLC
Classification: General Practice - 208D00000X
Entity Type: Organization

CLIA Number: 10D2274907

Address:
2123 W DR MARTIN LUTHER KING JR BLVD STE 101
TAMPA, FL
ZIP 33607
Phone: (813) 488-4801
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NODAL MEDICAL CENTER LLC is a general practice in Tampa, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee NODAL MEDICAL CENTER LLC NPI is 1114457272. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2123 W DR MARTIN LUTHER KING JR BLVD STE 101
TAMPA, FL
ZIP 33607-545
Phone: (813) 488-4801
Fax: (813) 405-4506

The provider's authorized official is Osvanny Nodal .
The authorized official title is Medical Doctor and has the following contact phone number (813) 488-4801.

The CLIA number assigned to this NPI record is 10D2274907 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/12/2017 and was last updated on 6/20/2019.


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
1208D00000XGeneral PracticeACN693FLORIDAYes

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: 4/28/2024

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