Provider Demographics
NPI:1588343214
Name:USF COLLEGE OF NURSING FACULTY PRACTICE MO BULL MEDICAL CLINIC
Entity type:Organization
Organization Name:USF COLLEGE OF NURSING FACULTY PRACTICE MO BULL MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:SAMYA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALMOUMANI
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:813-777-8827
Mailing Address - Street 1:12901 BRUCE B DOWNS BLVD # 22
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-4799
Mailing Address - Country:US
Mailing Address - Phone:813-777-8827
Mailing Address - Fax:888-554-7473
Practice Address - Street 1:12901 BRUCE B DOWNS BLVD # 22
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4799
Practice Address - Country:US
Practice Address - Phone:813-974-7043
Practice Address - Fax:888-554-7473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care