Provider Demographics
NPI:1003359514
Name:SARROCA MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:SARROCA MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERCEDES
Authorized Official - Middle Name:DE LA CARIDAD
Authorized Official - Last Name:SARROCA
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:813-401-4392
Mailing Address - Street 1:3709 W HAMILTON AVE
Mailing Address - Street 2:UNIT 9.
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-4015
Mailing Address - Country:US
Mailing Address - Phone:813-374-7608
Mailing Address - Fax:813-374-9124
Practice Address - Street 1:3709 W HAMILTON AVE
Practice Address - Street 2:UNIT 9.
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-4015
Practice Address - Country:US
Practice Address - Phone:813-374-7608
Practice Address - Fax:813-374-9124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-01
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1235580929OtherINDIVIDUAL