Basic Information
| Provider Information | |||||||||
| NPI: | 1194493239 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TAMPA GENERAL PROVIDER NETWORK INC | ||||||||
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| OtherOrganizationName: | TAMPA GENERAL PROVIDER NETWORK INC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 95000-7370 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191957370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8552353496 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5 TAMPA GENERAL CIR STE 860 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336063573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8136606950 | ||||||||
| FaxNumber: | 8136606622 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2021 | ||||||||
| LastUpdateDate: | 08/17/2022 | ||||||||
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| AuthorizedOfficialLastName: | SCHWARZBERG | ||||||||
| AuthorizedOfficialFirstName: | ABRAHAM | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5612533980 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 08/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | 208G00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.