1689751950 NPI number — TAMPA MEDICAL PARTNERS INC.

Table of content: (NPI 1689751950)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689751950 NPI number — TAMPA MEDICAL PARTNERS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TAMPA MEDICAL PARTNERS INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689751950
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8140 PICTON WAY
Provider Second Line Business Mailing Address:
ST#103
Provider Business Mailing Address City Name:
TRINITY
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34655-1792
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
727-375-9700
Provider Business Mailing Address Fax Number:
727-375-9720

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8140 PICTON WAY
Provider Second Line Business Practice Location Address:
ST#103
Provider Business Practice Location Address City Name:
TRINITY
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34655-1792
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-375-9700
Provider Business Practice Location Address Fax Number:
727-375-9720
Provider Enumeration Date:
11/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KRUDO
Authorized Official First Name:
LOUIS
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/OWNER
Authorized Official Telephone Number:
727-375-9700

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  OS6009 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 043965700 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1295732642 . This is a "NPI GARY R LEVINE DO" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: K1810 . This is a "MEDICARE TAMPA MEDICAL PARTNERS ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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