CUSTOM CARE MEDICAL CENTER LLC – NPI #1487455341
Clinic/Center

A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Health Care Provider Taxonomy Code for Clinic/Center

CUSTOM CARE MEDICAL CENTER LLC is an AHC clinic located in TAMPA, FL. NPPES has assigned the NPI number 1487455341 to CUSTOM CARE MEDICAL CENTER LLC on March 24, 2025. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261Q00000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CUSTOM CARE MEDICAL CENTER LLC below.

NPI Profile for
CUSTOM CARE MEDICAL CENTER LLC

NPI Number
1487455341
Enumeration Date

(more than a year ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CUSTOM CARE MEDICAL CENTER LLC
Primary location
1931 W MARTIN LUTHER KING JR BLVD
STE E
TAMPA, FL 33607
Phone: (813) 515-6676 Fax: (813) 515-6685
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DOUGLAS BURKS
OWNER
Phone: (813) 515-6676
Updated
Certification Date
Mar 20, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261Q00000X
- Clinic/Center (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.