Provider Demographics
NPI:1245496918
Name:BARTOW MEDICAL CENTER, LLC
Entity type:Organization
Organization Name:BARTOW MEDICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MISS
Authorized Official - First Name:NAMRATA
Authorized Official - Middle Name:A
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-251-1366
Mailing Address - Street 1:1056 N BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-3301
Mailing Address - Country:US
Mailing Address - Phone:727-251-1366
Mailing Address - Fax:813-968-5306
Practice Address - Street 1:1056 N BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-3301
Practice Address - Country:US
Practice Address - Phone:727-251-1366
Practice Address - Fax:813-968-5306
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL CARE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-01
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100706174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty