Provider Type Icon

ROOT CAUSE MEDICAL CLINIC LLC NPI 1962854802


NPI Information

NPI: 1962854802
Provider Name: ROOT CAUSE MEDICAL CLINIC LLC

Former Legal Business Name: ROOT CAUSE MEDICAL CLINIC INC

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
15049 BRUCE B DOWNS BLVD
TAMPA, FL
ZIP 33647
Phone: (937) 216-9048
Get Directions

ROOT CAUSE MEDICAL CLINIC LLC is a general practice in Tampa, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee ROOT CAUSE MEDICAL CLINIC LLC NPI is 1962854802. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Root Cause Medical Clinic Inc.

The provider's business location address is:

15049 BRUCE B DOWNS BLVD
TAMPA, FL
ZIP 33647-388
Phone: (937) 216-9048
Fax: (844) 828-3997

The provider's authorized official is Jordan Matthew Axe .
The authorized official title is Owner/president and has the following contact phone number (937) 216-9048.

The enumeration date for this NPI number is 7/4/2016 and was last updated on 2/23/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorNo
2207L00000XAnesthesiologyNo
3207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismNo
4225100000XPhysical TherapistNo
5363A00000XPhysician AssistantNo
6363L00000XNurse PractitionerNo
7363LA2200XNurse PractitionerAdult HealthNo
8363LF0000XNurse PractitionerFamilyNo
9363LG0600XNurse PractitionerGerontologyNo
10208D00000XGeneral PracticeYes

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

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.