Provider Demographics
NPI:1619586757
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:PROVIDER SERVICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AGUEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-278-0200
Mailing Address - Street 1:12171 SW 268TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-8001
Mailing Address - Country:US
Mailing Address - Phone:305-278-0200
Mailing Address - Fax:305-851-4110
Practice Address - Street 1:8340 STONE RUN CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1879
Practice Address - Country:US
Practice Address - Phone:813-712-1726
Practice Address - Fax:813-925-7640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty