| Organization Name: | DWIC OF TAMPA BAY, INC. |
| NPI Number: | 1801845011 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIM G. BUGIN (VP PAYOR CONTRACTING) |
| Mailing Address: | 801 W. Martin Luther King Boulevard Seffner |
| State: | FL US |
| Postal Code: | 335844635 |
| Phone Number: | 8136844424 |
| Fax Number: | 8136840797 |
| NPI Enumeration Date: | 05/08/2006 |
| NPI Last Update Date: | 11/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QU0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Urgent Care |
| Taxonomy Definition: | |