Provider Demographics
NPI:1922237007
Name:TRIPLE - I - CARE LLC
Entity Type:Organization
Organization Name:TRIPLE - I - CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PANOS
Authorized Official - Middle Name:
Authorized Official - Last Name:VASILOUDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-882-9986
Mailing Address - Street 1:5210 WEBB RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4518
Mailing Address - Country:US
Mailing Address - Phone:813-882-9986
Mailing Address - Fax:813-884-5616
Practice Address - Street 1:5535 MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-7370
Practice Address - Country:US
Practice Address - Phone:813-374-9172
Practice Address - Fax:813-374-9174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care