Divine Medical Center, Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

DIVINE MEDICAL CENTER, INC

Practice address

6107 Memorial Hwy Ste B
Tampa, FL 33615-4564

Phone

(813) 810-8650

NPI assigned

Feb 12, 2025

Last updated

Feb 12, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gelys Gongora, APRN

Title

President

Phone

(813) 810-8650

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1739318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1275348526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 MEMORIAL HWY STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336154564",
            "telephone_number": "813-810-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6107 MEMORIAL HWY STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336154564",
            "telephone_number": "813-810-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-12",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "GONGORA",
        "authorized_official_first_name": "GELYS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-810-8650",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Louise Divico, RN
• Divine Hands Home Care LLC
• Divine Home Health Care, Inc
• Divine Home Health Group, Inc
• Divine Inspiration LLC
• Divine Path Nemt, LLC
• Sachin Vijay Diwadkar, MD
• Jackie Dix, PHARMD
• Melody Dix, R.PH
• Aaron David Dixon, D.C.

• Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.