NPIMap

Organization Active NPI

West Waters Medical Center, LLC

  • Health Service Clinic/Center
  • Tampa, FL
National Provider Identifier
1447492830
Registry record updated Mar 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
HCC7342 Issued in FL
Legal business name
WEST WATERS MEDICAL CENTER, LLC
Practice address
3550 W Waters Ave
Suite 108
Tampa, FL 33614-2716
Phone
(813) 734-9218
Fax
(813) 374-9221
NPI assigned
Mar 31, 2009
Last updated
Mar 31, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2009

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

Authorized official

Name
Mr. Roberto Portal
Title
Manager
Phone
(813) 734-9218

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X HCC7342 FL Primary

Addresses

Primary practice location

3550 W Waters Ave
Suite 108
Tampa, FL 33614-2716

Mailing address

3550 W Waters Ave
Suite 108
Tampa, FL 33614-2716
Phone (813) 734-9218

National Provider Directory

National Provider Directory

Locations

3550 W Waters Ave
Ste 108
Tampa, FL 33614
Phone (813) 374-9218

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238457600000",
    "number": "1447492830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 W WATERS AVE",
            "address_2": "SUITE 108",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142716",
            "telephone_number": "813-734-9218",
            "fax_number": "813-374-9221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 W WATERS AVE",
            "address_2": "SUITE 108",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142716",
            "telephone_number": "813-734-9218",
            "fax_number": "813-374-9221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST WATERS MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-31",
        "last_updated": "2009-03-31",
        "status": "A",
        "authorized_official_last_name": "PORTAL",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "813-734-9218",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "HCC7342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; 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.