Provider Demographics
NPI:1881085827
Name:LOMINCHAR, AMILCAR M (MD)
Entity type:Individual
Prefix:DR
First Name:AMILCAR
Middle Name:M
Last Name:LOMINCHAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3832 W HUMPHREY ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1955
Mailing Address - Country:US
Mailing Address - Phone:813-440-4420
Mailing Address - Fax:813-502-0290
Practice Address - Street 1:3832 W HUMPHREY ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1955
Practice Address - Country:US
Practice Address - Phone:813-440-4420
Practice Address - Fax:813-502-0290
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13724-I208D00000X
FLACN869208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLACN869OtherMEDICAL LICENSE
FL019785900Medicaid
FLFL5407588OtherDEA