VERIMED HEALTH GROUP LLC - NPI NUMBER 1881940914

Summary

Provider Name: VERIMED HEALTH GROUP LLC

NPI Number: 1881940914

Clasification: Internal Medicine (207R00000X)

Address:
3000 MEDICAL PARK DR
SUITE 450
TAMPA, FL
ZIP 33613

Phone Number: (813) 972-5420



Detailed Information

VERIMED HEALTH GROUP LLC is an internist in Tampa, 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. The assigned NPI number for this provider is 1881940914 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

3000 MEDICAL PARK DR
SUITE 450
TAMPA, FL
ZIP 33613-680
Phone: (813) 972-5420
Fax: (813) 977-2021

The provider's authorized official is Gladymar Vrkic .
The authorized official title is Administrator and has the following contact phone number (813) 972-5420.

The enumeration date for this NPI number is 7/26/2012 and was last updated on 7/26/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207R00000X Internal Medicine ME101151 FL Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1881940914 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name VERIMED HEALTH GROUP LLC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 3000 MEDICAL PARK DR The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Second Line Business Practice Location Address SUITE 450 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name TAMPA The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name FL The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 336134680 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 8139725420 The telephone number associated with the location address of the provider being identified.
12 Provider Business Practice Location Address Fax Number 8139772021 The fax number associated with the location address of the provider being identified.
13 Provider Enumeration Date 7/26/2012 The date the provider was assigned a unique identifier (assigned an NPI).
14 Last Update Date 7/26/2012 The date that a record was last updated or changed.
15 Authorized Official Last Name VRKIC The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
16 Authorized Official First Name GLADYMAR The first name of the authorized official.
17 Authorized Official Title or Position ADMINISTRATOR The title or position of the authorized official.
18 Authorized Official Telephone Number 8139725420 The 10-position telephone number of the authorized official.
19 Healthcare Provider Taxonomy Code 1 207R00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
20 Provider License Number 1 ME101151 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
21 Provider License Number State Code 1 FL The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
22 Healthcare Provider Primary Taxonomy Switch 1 Y
23 Is Organization Subpart N
24 Authorized Official Name Prefix Text MRS.
25 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP The name of the organization provider. If the provider is an organization, this is the legal business name.

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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