St Jude Medical & Aesthetic Care Center, LLC
St Jude Medical & Aesthetic Care Center, LLC provides Dietary Manager services in Brandon, Florida. Licensed in Florida. Registered with an NPI since 2010.
- Licensed in
- FL
- In the registry since
- 2010
- Specialties on file
- 7
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
131 N Moon Ave Suites 3 & 4Brandon, FL 33510-4418 Not confirmed with CMS for 13 years — call before visiting
Phone: (813) 315-9898
Fax: (813) 438-5967
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Ophthalmology Physician (primary) | Taxonomy 207W00000X · Licence ME107980 (FL) |
|---|---|
| Dietary Manager | Taxonomy 132700000X |
| Personal Emergency Response Attendant | Taxonomy 146D00000X · Licence ME107980 (FL) |
| Addiction Medicine (Family Medicine) Physician | Taxonomy 207QA0401X · Licence ME107980 (FL) |
| Public Health & General Preventive Medicine Physician | Taxonomy 2083P0901X |
| General Practice Physician | Taxonomy 208D00000X · Licence ME107980 (FL) |
| Clinical Pharmacology Physician | Taxonomy 208U00000X · Licence ME107980 (FL) |
Record details
| NPI number | 1518260090 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Godwin Okoye — Medical Director · (813) 330-6613 |
| Other names | St. Jude Medical Center & Aesthetic Care |
| NPI enumerated | December 6, 2010 |
| Last updated in NPPES | October 8, 2013 |
| Mailing address | 4810 Portobello Cir, Valrico, FL 33596 |