Provider Demographics
NPI:1205362431
Name:RELIANCE MEDICAL CENTERS
Entity Type:Organization
Organization Name:RELIANCE MEDICAL CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-853-1543
Mailing Address - Street 1:3655 INNOVATION DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33812-4106
Mailing Address - Country:US
Mailing Address - Phone:863-619-5999
Mailing Address - Fax:863-619-5958
Practice Address - Street 1:3655 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33812-4106
Practice Address - Country:US
Practice Address - Phone:863-619-5999
Practice Address - Fax:863-619-5958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-09
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care