NPIMap

Organization Active NPI

MLK Medical Center

  • Clinic/Center
  • Tampa, FL
National Provider Identifier
1992139349
Registry record updated Aug 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MLK MEDICAL CENTER
Practice address
1936 W Dr Martin Luther King Jr Blvd Ste 209
Tampa, FL 33607-6530
Phone
(813) 443-2191
Fax
(813) 443-4823
NPI assigned
Aug 21, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2013

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

Authorized official

Name
Osvaldo Gonzalez
Title
Owner
Phone
(813) 443-2191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1936 W Dr Martin Luther King Jr Blvd Ste 209
Tampa, FL 33607-6530

Mailing address

1936 W Dr Martin Luther King Jr Blvd Ste 209
Tampa, FL 33607-6530
Phone (813) 443-2191

National Provider Directory

National Provider Directory
Tax ID family
MLK Medical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377043200000",
    "number": "1992139349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 W DR MARTIN LUTHER KING JR BLVD STE 209",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076530",
            "telephone_number": "813-443-2191",
            "fax_number": "813-443-4823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 W DR MARTIN LUTHER KING JR BLVD STE 209",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076530",
            "telephone_number": "813-443-2191",
            "fax_number": "813-443-4823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLK MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-21",
        "last_updated": "2013-08-21",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "OSVALDO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "18134432191"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "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 Aug 21, 2013; 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.