South Care Medical, LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

SOUTH CARE MEDICAL, LLC

Practice address

6822 W Waters Ave
Tampa, FL 33634

Phone

(813) 969-1700

NPI assigned

May 29, 2019

Last updated

May 29, 2019By 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

Alejandro Gonzalez

Title

Owner

Phone

(813) 770-7169

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1982261681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4522 W VILLAGE DR STE 202",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336243429",
            "telephone_number": "813-969-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6822 W WATERS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33634",
            "telephone_number": "813-969-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CARE MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ALEJANDRO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-770-7169"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Tampa, FL
• Providers in Tampa, FL by specialty
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.