Provider Demographics
NPI:1043480502
Name:AMERICAN CARE OF TAMPA INC.
Entity Type:Organization
Organization Name:AMERICAN CARE OF TAMPA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:305-278-0200
Mailing Address - Street 1:2600 INDUSTRIAL PARK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-7135
Mailing Address - Country:US
Mailing Address - Phone:863-666-6100
Mailing Address - Fax:863-665-6164
Practice Address - Street 1:2600 INDUSTRIAL PARK DR
Practice Address - Street 2:SUITE C
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-7135
Practice Address - Country:US
Practice Address - Phone:863-666-6100
Practice Address - Fax:863-665-6164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5943174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5943OtherFACILITY LICENSE