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GREATER TAMPA BAY PHYSICIAN NETWORK LLC NPI 1649604364


NPI Information

NPI: 1649604364
Provider Name: GREATER TAMPA BAY PHYSICIAN NETWORK, LLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 10D2008232

Address:
1615 PASADENA AVE S STE 430
SOUTH PASADENA, FL
ZIP 33707
Phone: (727) 397-0606
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GREATER TAMPA BAY PHYSICIAN NETWORK, LLC is an internal medicine in South Pasadena, FL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. GREATER TAMPA BAY PHYSICIAN NETWORK, LLC NPI is 1649604364. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1615 PASADENA AVE S STE 430
SOUTH PASADENA, FL
ZIP 33707-521
Phone: (727) 397-0606
Fax: (727) 397-6161

The provider's authorized official is William Tederick Johnson .
The authorized official title is Group Vice President/ao and has the following contact phone number (615) 372-3375.

The CLIA number assigned to this NPI record is 10D2008232 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2013 and was last updated on 10/15/2020.


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
1207RC0000XInternal MedicineCardiovascular DiseaseNo
2207R00000XInternal 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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.