OAKSTEAD PRIMARY CARE, INC.
Osteopathic Medicine at Darby Ridge Dr, Tampa, FL

License number
Florida ME90171
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: MANJARI ILESH PATEL M.D.
Title: PRESIDENT
Phone: (813) 968-9695
Address
Address
12855 Darby Ridge Dr, Tampa, FL 33624
National Provider ID: 1447201736
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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OAKSTEAD PRIMARY CARE, INC

Tampa, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Mar 27, 2006
Inactive since:
Sep 25, 2009
Addresses:
12855 Darby Rdg Rd, Tampa, FL 33624 (Physical)
12855 Darby Rdg Dr, Tampa, FL 33624
State ID:
P06000043270
Business type:
Florida Profit Corporation
President:
Manjari Patel President, inactive, 12855 Darby Rdg Rd, Tampa, FL 33624 (Physical)
Agent:
Patel, Ilesh,12855 Darby Rdg Rd, Tampa, FL 33624 (Physical)
EIN:
204567631

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