Organization Active NPI

Personal Medical Center, Inc.

  • Clinic/Center
  • Tampa, FL
National Provider Identifier
1619155132
Registry record updated Feb 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
HCC6579 Issued in FL
Legal business name
PERSONAL MEDICAL CENTER, INC.
Practice address
3911 W Waters Ave Ste 12
Tampa, FL 33614-1950
Phone
(813) 935-1340
NPI assigned
Feb 6, 2008
Last updated
Feb 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2008

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

Authorized official

Name
Ariel Santos
Title
Owner
Phone
(813) 935-1340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X HCC6579 FL Primary

Addresses

Primary practice location

3911 W Waters Ave Ste 12
Tampa, FL 33614-1950

Mailing address

3911 W Waters Ave Ste 12
Tampa, FL 33614-1950

National Provider Directory

National Provider Directory

Locations

3911 W Waters Ave
Ste 12
Tampa, FL 33614
Phone (813) 935-1340

Practitioners & affiliated clinicians

Practitioners 2

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": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202256000000",
    "number": "1619155132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 W WATERS AVE STE 12",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336141950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 W WATERS AVE STE 12",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336141950",
            "telephone_number": "813-935-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "ARIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-935-1340"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "HCC6579",
            "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 Feb 6, 2008; 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.