Provider Demographics
NPI:1649226473
Name:SAPIEN DIAGNOSTICS INC
Entity Type:Organization
Organization Name:SAPIEN DIAGNOSTICS INC
Other - Org Name:FLORIDA AVENUE WALK-IN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:813-935-8707
Mailing Address - Street 1:8407 NORTH FLORIDA AVENUE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604
Mailing Address - Country:US
Mailing Address - Phone:813-935-8707
Mailing Address - Fax:813-935-8704
Practice Address - Street 1:8407 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-3015
Practice Address - Country:US
Practice Address - Phone:813-935-8707
Practice Address - Fax:813-935-8704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 6319261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care