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 Reports
Inspection 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

NamePositionOwnership
CHABELI LOVAGNINI CASTILLOBOARD MEMBER/OFFICER100%
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.