PHILOTEMO HEALTH AND WELLNESS NPI 1639850563

NPI Information

  • NPI: 1639850563
  • Provider Name: PHILOTEMO HEALTH AND WELLNESS
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 10D2297595
  • Address: 4010 W STATE ST
    TAMPA, FL
    ZIP 33609
  • Phone: (813) 758-0305

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NPI Details

PHILOTEMO HEALTH AND WELLNESS is a primary care clinic center in Tampa, FL. PHILOTEMO HEALTH AND WELLNESS NPI is 1639850563. The provider is registered as an organization entity type.

The provider's business location address is:

4010 W STATE ST
TAMPA, FL
ZIP 33609-264
Phone: (813) 758-0305

The provider's authorized official is Edith L Kavouklis .
The authorized official title is Owner/mgr and has the following contact phone number (813) 758-0305.

The CLIA number assigned to this NPI record is 10D2297595 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/25/2023 and was last updated on 7/25/2023.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareYes

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: 11/21/2025

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