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NORTHDALE FAMILY DR NPI 1285024380


NPI Information

NPI: 1285024380
Provider Name: NORTHDALE FAMILY DR
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 10D0977835

Address:
3865 NORTHDALE BLVD
TAMPA, FL
ZIP 33624
Phone: (813) 960-4401
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NORTHDALE FAMILY DR 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. NORTHDALE FAMILY DR NPI is 1285024380. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3865 NORTHDALE BLVD
TAMPA, FL
ZIP 33624-861
Phone: (813) 960-4401

The provider's authorized official is Yakub Ahmed Pothiawala .
The authorized official title is Medical Doctor and has the following contact phone number (813) 960-4401.

The CLIA number assigned to this NPI record is 10D0977835 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/27/2015 and was last updated on 1/27/2015.


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 MedicineME0070225FLORIDAYes

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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