Provider Demographics
NPI:1265975957
Name:FLORIDA HEALTH SCIENCES CENTER INC
Entity type:Organization
Organization Name:FLORIDA HEALTH SCIENCES CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:HERBERT
Authorized Official - Last Name:DOCOBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-844-7678
Mailing Address - Street 1:10740 PALM RIVER RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-4572
Mailing Address - Country:US
Mailing Address - Phone:813-660-6500
Mailing Address - Fax:813-660-6679
Practice Address - Street 1:10740 PALM RIVER RD
Practice Address - Street 2:SUITE 120
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4572
Practice Address - Country:US
Practice Address - Phone:813-660-6500
Practice Address - Fax:813-660-6679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
FLPH304763336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2166672OtherPK