Basic Information
Provider Information | |||||||||
NPI: | 1235196510 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | FLORIDA HEALTH SCIENCES CENTER INC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | TAMPA GENERAL HOSPITAL | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 1289 | ||||||||
Address2: |   | ||||||||
City: | TAMPA | ||||||||
State: | FL | ||||||||
PostalCode: | 336011289 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8138447000 | ||||||||
FaxNumber: | 8138444595 | ||||||||
Practice Location | |||||||||
Address1: | 1 TAMPA GENERAL CIRCLE | ||||||||
Address2: |   | ||||||||
City: | TAMPA | ||||||||
State: | FL | ||||||||
PostalCode: | 33606 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8138447000 | ||||||||
FaxNumber: | 8138444595 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/28/2006 | ||||||||
LastUpdateDate: | 07/25/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | COURIS | ||||||||
AuthorizedOfficialFirstName: | JOHN | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
AuthorizedOfficialTelephone: | 8138444520 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | MR. | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 07/25/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QE0002X | 4044 | FL | N |   | Ambulatory Health Care Facilities | Clinic/Center | Emergency Care | 261QE0700X | 4044 | FL | N |   | Ambulatory Health Care Facilities | Clinic/Center | End-Stage Renal Disease (ESRD) Treatment | 261QM1300X | 4044 | FL | N |   | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | 261QP2300X | 4044 | FL | N |   | Ambulatory Health Care Facilities | Clinic/Center | Primary Care | 273R00000X | 4044 | FL | N |   | Hospital Units | Psychiatric Unit |   | 273Y00000X | 4044 | FL | N |   | Hospital Units | Rehabilitation Unit |   | 3416A0800X | 4044 | FL | N |   | Transportation Services | Ambulance | Air Transport | 282N00000X | 4044 | FL | Y |   | Hospitals | General Acute Care Hospital |   |
No ID Information.