Main Street Medical Centers

LBN: Main Street Medical Llc
Main Street Medical Centers is an health care organization with primary practice located at 10549 N Florida Ave Ste A/I , Tampa FL 33612-6707. The organization recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adult Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Psychiatry, Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Primary Care. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty. Main Street Medical Llc can be contacted via phone (813) 220-1400, or through Banjoko, Stephen O via phone (212) 257-0225.

Contact Information

Primary practice address
10549 N Florida Ave Ste A/I Tampa FL 33612-6707
Phone: (813) 220-1400
Fax: (813) 440-6484
Website:
Map and Directions
Authorized official contact:
Name: Banjoko, Stephen O
Phone: (212) 257-0225

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1487079505
LBN Legal business name Main Street Medical Llc
DBA Doing business as Main Street Medical Centers
Authorized official Banjoko, Stephen O
Entity Organization
Organization subpart 1 No
Enumeration date Feb 26th, 2014
Last updated Feb 7th, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487079505 NPPES
Florida Other LK078 MEDICARE
Florida MEDICAID 104624600 MEDICARE

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