Dedicated Senior Medical Center St. Petersburg, LLC.
Specialist in St. Petersburg, FL. Organization (NPI-2).
NPI number1801320528
StatusActive
Last updated in NPPESApr 19, 2017
Details
- NPI
- 1801320528
- Entity type
- Organization (NPI-2)
- Legal business name
- Dedicated Senior Medical Center St. Petersburg, LLC.
- Organization subpart
- No
- Enumeration date
- Apr 19, 2017
- Last updated
- Apr 19, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
| 332900000X | Non-Pharmacy Dispensing Site | – | – |
Practice location
901 22nd Avenue SouthDedicated Senior Medical Center St. Petersburg, LLC.
St. Petersburg, FL 33705
Phone 305-831-4761
Mailing address
1395 Nw 167th StreetChen Medical Corporate Office
Miami Gardens, FL 33169
Phone 305-831-4761 · Fax 305-831-4761
Authorized official
Gladys Fernandez-Cortes
Managing Director
3054984034
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