Dedicated Senior Medical Center East Tampa, LLC.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

DEDICATED SENIOR MEDICAL CENTER EAST TAMPA, LLC.

Practice address

3128 East Hillsborough Avenue
Dedicated Senior Medical Center East Tampa, LLC.
Tampa, FL 33610

Phone

(305) 831-4761

NPI assigned

Apr 19, 2017

Organization subpart

No

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

Authorized official

Name

Gladys Fernandez-Cortes

Title

Managing Director

Phone

(305) 498-4034

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1619401338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH STREET",
            "address_2": "CHEN MEDICAL CORPORATE OFFICE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "33169",
            "telephone_number": "305-831-4761",
            "fax_number": "305-831-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3128 EAST HILLSBOROUGH AVENUE",
            "address_2": "DEDICATED SENIOR MEDICAL CENTER EAST TAMPA, LLC.",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33610",
            "telephone_number": "305-831-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEDICATED SENIOR MEDICAL CENTER EAST TAMPA, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ-CORTES",
        "authorized_official_first_name": "GLADYS",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "305-498-4034"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isis-Leilani Declouet-Grant
• Christopher Michael Declue, MD
• Terry Joe Declue, M.D.
• Vicki Alessi Declue, RPH
• Christina Decoveny, DPT
• Dedicated Senior Medical Center of Florida, LLC
• Dedicated Senior Medical Centers of Florida, LLC
• Dedicated Senior Medical Centers of Florida, LLC
• Dustin Dedomenico, DMD MS
• Ralph J Dedomenico, DMD

• Specialist in Tampa, FL
• Providers in Tampa, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.