Provider Demographics
NPI:1457192650
Name:OASIS CARE CLINIC INC
Entity type:Organization
Organization Name:OASIS CARE CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IMEE
Authorized Official - Middle Name:MATEO
Authorized Official - Last Name:DOWNING
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:702-612-5214
Mailing Address - Street 1:13107 BEE BLOSSOM PL
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-4080
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4830 W KENNEDY BLVD STE 600
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2584
Practice Address - Country:US
Practice Address - Phone:813-600-3559
Practice Address - Fax:813-602-0896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty