Provider Demographics
NPI:1891217972
Name:VERIMED HEALTH GROUP ZEPHYRHILLS LLC
Entity Type:Organization
Organization Name:VERIMED HEALTH GROUP ZEPHYRHILLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-469-6334
Mailing Address - Street 1:38034 MEDICAL CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33540-1383
Mailing Address - Country:US
Mailing Address - Phone:813-788-5531
Mailing Address - Fax:813-783-7178
Practice Address - Street 1:38034 MEDICAL CENTER AVE
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33540-1383
Practice Address - Country:US
Practice Address - Phone:813-788-5531
Practice Address - Fax:813-783-7178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018078400Medicaid
FL018078400Medicaid