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WEST TAMPA MEDICAL GROUPLLC NPI 1144522988


NPI Information

NPI: 1144522988
Provider Name: WEST TAMPA MEDICAL GROUP,LLC

Doing Business As: REVELLO MEDICAL CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D2104991

Address:
2942 W COLUMBUS DR STE 106
TAMPA, FL
ZIP 33607
Phone: (813) 873-8071
Get Directions

WEST TAMPA MEDICAL GROUP,LLC is a family medicine in Tampa, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WEST TAMPA MEDICAL GROUP,LLC NPI is 1144522988. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Revello Medical Center.

The provider's business location address is:

2942 W COLUMBUS DR STE 106
TAMPA, FL
ZIP 33607-286
Phone: (813) 873-8071
Fax: (813) 877-4031

The provider's authorized official is Antonio Calvo .
The authorized official title is Operations/business Manager and has the following contact phone number (813) 873-8071.

The CLIA number assigned to this NPI record is 10D2104991 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/30/2010 and was last updated on 11/30/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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