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1450 COURT ST
CLEARWATER, FL 33756
Phone: (727) 772-0677
County: Pinellas

Mailing Address

2707 N HIMES AVE
TAMPA, FL 33607
County: Hillsborough
Website: http://rivasmc.com

Emergency Actions:

None
Facility/Provider Type: Health Care Clinic
Medical or Clinic Director: PIER DENEK FRANK MD
Administrator: JACQUELINE GONZALEZ
Financial Officer: BENJAMIN RIVAS JR
Owner/Licensee: PHYSICIAN'S HEALTH INC
Owner/Licensee Since: 12/29/2006
NamePositionOwnership
BENJAMIN RIVAS JRBOARD MEMBER/OFFICER60%
CHRISTOPHER B RIVASBOARD MEMBER/OFFICER40%
JACQUELINE GONZALEZBOARD MEMBER/OFFICER0%
Profit Status: For-Profit
Licensed Beds: Not Available
AHCA Number (File Number): 2216
AHCA Field Office: 05
License Number: 4753
Current License Effective: 4/20/2019
Expires: 4/19/2021
License Status: LICENSED

Services/Characteristics:

Type :  Fixed Location


Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.
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