M & M Medical Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME88205 Issued in FL

Legal business name

M & M MEDICAL CLINIC

Practice address

1911 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6509

Phone

(813) 872-2777

Fax

(813) 872-2775

NPI assigned

Jan 10, 2008

Last updated

Jan 10, 2008By 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

Muluken D Frew, MD

Title

Owner

Phone

(813) 872-2777

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• M & M Medical Clinic, LLC

  dba First Care Walk-In Clinic

  • Urgent Care Clinic/Center
  • Tampa, FL
  • NPI 1588992713

  O20080519000493

  Same enrollment

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1417133372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 441",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239700441",
            "telephone_number": "434-447-8580",
            "fax_number": "434-447-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 W DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076509",
            "telephone_number": "813-872-2777",
            "fax_number": "813-872-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M & M MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "FREW",
        "authorized_official_first_name": "MULUKEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-872-2777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME88205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "35102",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Selena Lyvers-Rouse
• M & B Dental Designs, LLC
• M & B Sebastian LLC (Green Space Health)
• M & D Care, Inc. D/B/a Women's Health Care (Women's Health Care)
• M & H Hillsborough Center
• M & M Medical Clinic, LLC (First Care Walk-In Clinic)
• M & P Loving Adult Day Care LLC
• M Cariaga M D P a
• M Paul Nestor DDS PA
• M Square Capital Group LLC (Medicare MTM Services)

• Internal Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.