Provider Demographics
NPI:1609448042
Name:ARETXA MEDICAL CENTER INC
Entity Type:Organization
Organization Name:ARETXA MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:MAGDALENA
Authorized Official - Last Name:AUSSENDORF
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:813-598-7711
Mailing Address - Street 1:15809 SAPWOOD ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1627
Mailing Address - Country:US
Mailing Address - Phone:813-598-7711
Mailing Address - Fax:
Practice Address - Street 1:15809 SAPWOOD ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-1627
Practice Address - Country:US
Practice Address - Phone:813-598-7711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service