| Organization Name: | IDITALYA 10 MEDICAL CENTER INC |
| NPI Number: | 1447643291 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALFREDO FERNANDEZ (OWNER) |
| Mailing Address: | 4600 N Habana Ave Suite 20 Tampa |
| State: | FL US |
| Postal Code: | 336147112 |
| Phone Number: | 8138774201 |
| Fax Number: | 8003602601 |
| NPI Enumeration Date: | 03/17/2015 |
| NPI Last Update Date: | 08/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |