Provider Demographics
NPI:1316464746
Name:A & A MEDICAL CENTER,LLC
Entity type:Organization
Organization Name:A & A MEDICAL CENTER,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:CECILIA
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-450-3707
Mailing Address - Street 1:2916 W WATERS AVE STE A2
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1869
Mailing Address - Country:US
Mailing Address - Phone:813-450-3709
Mailing Address - Fax:813-450-3709
Practice Address - Street 1:2916 W WATERS AVE STE A2
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1869
Practice Address - Country:US
Practice Address - Phone:813-450-3709
Practice Address - Fax:813-450-3709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center