AVITA MEDICAL CLINIC, LLC (NPI# 1992302574) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992302574 |
| Entity Type | Organization |
| Organization Name | AVITA MEDICAL CLINIC, LLC |
| Practice Address |
14831 N Florida Ave Tampa FL 33613-1825 |
| Practice Telephone | 8133302737 |
| Practice Fax Number | 8132109205 |
| Mailing Telephone | 8132100982 |
| Mailing Fax Number | 8132109205 |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-06 |
| Authorized Official Name | MRS. JENNY M SEGARRA (PRESIDENT) |
| Authorized Official Telephone | 8133302737 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
14831 N FLORIDA AVE |
| City | TAMPA |
| State | FL |
| Zip Code | 33613-1825 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649877671 | Lisandra Isabelle Raba | Behavior Technician | 3299 Usf Banyan Circle, Tampa, FL 33613 | 2020-10-02 |
| 1184250490 | Stetho Md LLC | Family Medicine | 1707 E Bearss Ave, Tampa, FL 33613 | 2020-03-18 |
| 1174187645 | Renee Pinheiro | Student in an Organized Health Care Education/Training Program | Usf Health Morsani College of Medicine, 12901 Bruce B Downs Blvd. Mdc5, Tampa, FL 33613 | 2019-04-30 |
| 1104388842 | Heartbeat Home Health Care LLC | Home Health | 13542 N Florida Ave Ste 209-b, Tampa, FL 33613 | 2019-04-02 |
| 1437625357 | Carierx LLC | Pharmacy | 15511 N. Florida Avenue, Ste 601, Tampa, FL 33613 | 2018-10-18 |
| 1205312980 | Sabina Vlaeva | Dentist | Affordable Dentures & Implants, 14936 N Florida Avenue Ste 101, Tampa, FL 33613 | 2018-07-16 |
| 1780170266 | Joy M. Alexander | Driver | 14209 Cyber Pl Apt 102, Tampa, FL 33613 | 2018-07-08 |
| 1598289829 | Lillian Perez | Social Worker | 13542 N Florida Avenue, Suite 210, Tampa, FL 33613 | 2017-07-28 |
| 1134640386 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 3100 E Fletcher Ave Ste A165, Tampa, FL 33613 | 2017-06-28 |
| 1770016099 | Marcus Bruno | Physician Assistant | 13701 Bruce B Downs Blvd., Tampa, FL 33613 | 2017-04-04 |
| Find all providers in zip 33613 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1760080212 | Summit Health Multi Specialty of Florida LLC | General Practice | 1881 W Kennedy Blvd Ste D, Tampa, FL 33606-1611 | 2020-10-15 |
| 1619586757 | American Care of Tampa, Inc. | General Practice | 8340 Stone Run Ct, Tampa, FL 33615-1879 | 2020-07-24 |
| 1124652425 | Vivant Medical Group LLC | General Practice | 6214 Memorial Hwy Ste B, Tampa, FL 33615-4507 | 2020-02-25 |
| 1003453499 | Healmi Technologies, LLC | General Practice | 3109 W Dr Martin Luther King Jr Blvd Ste 111, Tampa, FL 33607-6237 | 2019-12-04 |
| 1023507407 | Mildred Catherine Conneely | General Practice | 1701 W Jetton Ave, Tampa, FL 33606-3026 | 2018-05-01 |
| 1144725557 | John Henry Hoenemeyer II | General Practice | 325 W Frierson Ave, Tampa, FL 33603-1932 | 2018-03-27 |
| 1568980464 | Drsoncalls | General Practice | 449 S 12th St., Unit 2801, Tampa, FL 33602 | 2017-08-31 |
| 1033635149 | Peak Payer Solutions, Inc. | General Practice | 12332 Race Track Road, Tampa, FL 33626 | 2017-08-21 |
| 1114457272 | Nodal Medical Center LLC | General Practice | 2123 W Dr Martin Luther King Jr Blvd Ste 101, Tampa, FL 33607-6545 | 2017-06-12 |
| 1831624014 | Blake Jeffrey Fernandez | General Practice | 6101 Webb Rd Ste 101, Tampa, FL 33615-2859 | 2017-04-26 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.