| NPI | 1528624053 |
|---|---|
| Doing Business As | PHOENIX MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | RICARDO A GOMEZ FERNANDEZ Administrator 813-352-8305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208D00000X General Practice | |
| 261Q00000X Clinic/Center | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2022-10-10 |