Provider Demographics
NPI:1326375122
Name:ST ISABEL MEDICAL CENTER INC
Entity Type:Organization
Organization Name:ST ISABEL MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHOY
Authorized Official - Middle Name:P
Authorized Official - Last Name:ESPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-443-4575
Mailing Address - Street 1:2901 W SAINT ISABEL ST STE E
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6350
Mailing Address - Country:US
Mailing Address - Phone:813-443-4575
Mailing Address - Fax:813-443-4578
Practice Address - Street 1:2901 W SAINT ISABEL ST STE E
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6350
Practice Address - Country:US
Practice Address - Phone:813-443-4575
Practice Address - Fax:813-443-4578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM23911261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy