Provider Profile
BLACKSTONE MEDICAL SERVICES LLC
Health Care Clinic
FACILITY PROFILE
Street Address
- 550 N REO ST, STE 250
TAMPA, FL 33609
County: Hillsborough - Phone: (813) 831-2727
Mailing Address
- 4030 HENDERSON BLVD # 145
TAMPA, FL 33629-4940
County: Hillsborough - Phone: (813) 831-2727
AHCA Reports
Inspection ReportsInspection Details
Facility Information:
| Facility/Provider Type: | Health Care Clinic | |||||||||||||||
| Medical or Clinic Director: | NAVEEN PADDU | |||||||||||||||
| Administrator: | VICK TIPNES | |||||||||||||||
| Owner/Licensee: | BLACKSTONE MEDICAL SERVICES LLC | |||||||||||||||
| Owner/Licensee Since: | 6/6/2011 | |||||||||||||||
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| Profit Status: | For-Profit | |||||||||||||||
| Licensed Beds: | Not Available | |||||||||||||||
| AHCA Number (File Number): | 9742 | |||||||||||||||
| AHCA Field Office: | 06 | |||||||||||||||
| License Number: | 9231 | |||||||||||||||
| Current License Effective: | 11/20/2023 | |||||||||||||||
| Current License Expires: | 11/19/2025 | |||||||||||||||
| License Status: | LICENSED | |||||||||||||||
Services/Characteristics
| Type: | Portable Equipment Provider |
Important information and facility/provider definitions can be found in the Glossary.
Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.