WATERS MEDICAL CLINIC LLC NPI 1336467208

NPI Information

NPI: 1336467208
Provider Name: WATERS MEDICAL CLINIC, LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 10D1041032

Address:
4040 W WATERS AVE
SUITE 103
TAMPA, FL
ZIP 33614
Phone: (813) 885-9091
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WATERS MEDICAL CLINIC, LLC is a primary care clinic center in Tampa, FL. WATERS MEDICAL CLINIC, LLC NPI is 1336467208. The provider is registered as an organization entity type.

The provider's business location address is:

4040 W WATERS AVE
SUITE 103
TAMPA, FL
ZIP 33614-958
Phone: (813) 885-9091
Fax: (813) 885-3527

The provider's authorized official is Thanhmy T Nguyen .
The authorized official title is Operating Manager and has the following contact phone number (813) 885-9091.

The CLIA number assigned to this NPI record is 10D1041032 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/17/2010 and was last updated on 11/23/2012.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

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: 5/5/2024

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