WATERS MEDICAL CLINIC, LLC (NPI# 1336467208) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336467208 |
| Entity Type | Organization |
| Organization Name | WATERS MEDICAL CLINIC, LLC |
| Practice Address |
4040 W Waters Ave Suite 103 Tampa FL 33614-1958 |
| Mailing Address |
Po Box 261825 Tampa FL 33685-1825 |
| Practice Telephone | 8138859091 |
| Practice Fax Number | 8138853527 |
| Mailing Telephone | 8138859091 |
| Mailing Fax Number | 8138853527 |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2012-11-23 |
| Authorized Official Name | DR. THANHMY T NGUYEN (OPERATING MANAGER) |
| Authorized Official Telephone | 8138859091 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
4040 W WATERS AVE SUITE 103 |
| City | TAMPA |
| State | FL |
| Zip Code | 33614-1958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285624759 | Thanhmy Nguyen | Internal Medicine | 4040 W Waters Ave, Suite 900, Tampa, FL 33614-1958 | 2005-10-26 |
| 1508335357 | Louis T Perez | Technician/Technologist | 4040 W Waters Ave, Tampa, FL 33614-1958 | 2018-11-21 |
| 1215305214 | Injury Wellness Clinic Inc | Chiropractor | 4040 W Waters Ave, Suite 107, Tampa, FL 33614-1958 | 2015-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134733082 | Robin Rollena Stewart | Home Health | 9537 Lazy Lane, Apt 302, Tampa, FL 33614 | 2020-09-08 |
| 1346885761 | David Joseph Page | Nurse Practitioner | St. Joseph's Behavioral Health Center, 4918 N. Habana Ave, Tampa, FL 33614 | 2019-11-08 |
| 1134687411 | Ramon Chang Adult Family Care Home LLC | Custodial Care Facility | 2607 W Humphrey St, Tampa, FL 33614 | 2019-03-06 |
| 1134600612 | Senior Point Assisted Living Facility, LLC | Assisted Living Facility | 2940 W Hillsborough Ave, Tampa, FL 33614 | 2018-08-23 |
| 1306361266 | Larry Valdes | Assisted Living Facility | 4402 W Minnehaha St, Tampa, FL 33614 | 2017-08-11 |
| 1982128062 | Jaime F Casellas Md Corp | Internal Medicine | 4600 N Habana Ave Suit #13, Tampa, FL 33614 | 2017-07-31 |
| 1891219119 | Waveney Gittens-williams | Alzheimer Center (Dementia Center) | 3706 W. Idle Wild Cir #203, Tampa, FL 33614 | 2017-07-28 |
| 1750811857 | Syerita Nicole Morris | Counselor | 6800 N Dale Marby Hwy, Ste 164, Tampa, FL 33614 | 2017-06-13 |
| 1447786124 | Lisa Moy | Case Manager/Care Coordinator | 4001 W. Dr. Martin Luther King Jr. Blvd., Tampa, FL 33614 | 2017-05-02 |
| 1750813804 | Joshua Martin Good | Physical Therapy Assistant | 3363 W. Waters Avenue, Suite 700, Tampa, FL 33614 | 2017-03-29 |
| Find all providers in zip 33614 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720690704 | Celena Vinent Carbonell M.d., P.a. | Clinic/Center | 1001 N Macdill Ave Ste D, Tampa, FL 33607-5152 | 2020-08-20 |
| 1912528290 | Advanced Mobile Medical Services | Clinic/Center | 2136 W. Mlk Blvd, Tampa, FL 33607 | 2020-04-28 |
| 1356976401 | Healthworks Med Group of Florida P A | Clinic/Center | 8705 Henderson Rd, Tampa, FL 33634-1143 | 2020-03-10 |
| 1720639453 | Careatc | Clinic/Center | 4107 N Himes Ave Ste 101, Tampa, FL 33607-6645 | 2019-09-24 |
| 1023572591 | Cheryl A Reed Md LLC | Clinic/Center | 6101 Webb Rd Ste 207, Tampa, FL 33615-2865 | 2019-01-29 |
| 1629579339 | Ohc Primary LLC | Clinic/Center | 912 Channelside Dr Ste 2103, Tampa, FL 33602-4227 | 2018-02-27 |
| 1649778663 | Florida Advanced Acupuncture | Clinic/Center | 14003 N Dale Mabry Hwy, Tampa, FL 33618-2459 | 2018-01-24 |
| 1174895411 | Inspire Medical Clinic LLC | Clinic/Center | 9804 North 56th St., Tampa, FL 33617 | 2012-02-02 |
| 1891064275 | Ar Enterprises of Hillsborough County | Clinic/Center | 6323 Memorial Hwy # D-1, Tampa, FL 33615-4509 | 2011-12-14 |
| 1568782134 | West Tampa Medical Clinic | Clinic/Center | 2309 W Martin Luther King Jr Blvd, Suite 5, Tampa, FL 33607 | 2010-06-07 |
| 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.