Provider Profile
INTERNAL MEDICINE CENTER CORP
Health Care Clinic
FACILITY PROFILE
Street Address
- 710 OAKFIELD DR STE 102
BRANDON, FL 33511-4931
County: Hillsborough - Phone: (813) 381-3242
Mailing Address
- 710 OAKFIELD DR STE 102
BRANDON, FL 33511-4931
County: Hillsborough - Phone: (813) 682-7765
AHCA Reports
Inspection ReportsInspection Details
Facility Information:
Facility/Provider Type: | Health Care Clinic | ||||||
Medical or Clinic Director: | LOURSE R ROSARIO LUGO | ||||||
Administrator: | CHABELI LOVAGNINI CASTILLO | ||||||
Owner/Licensee: | INTERNAL MEDICINE CENTER CORP | ||||||
Owner/Licensee Since: | 12/23/2020 | ||||||
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Profit Status: | For-Profit | ||||||
Licensed Beds: | Not Available | ||||||
AHCA Number (File Number): | 13435 | ||||||
AHCA Field Office: | 06 | ||||||
License Number: | 12561 | ||||||
Current License Effective: | 12/23/2024 | ||||||
Current License Expires: | 12/22/2026 | ||||||
License Status: | LICENSED |
Services/Characteristics
Specialty: | PIP Recipient |
Type: | Fixed Location |
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.