Basic Information
Provider Information
NPI: 1487328936
EntityType: 2
ReplacementNPI:  
OrganizationName: TAMPA FAMILY HEALTH CENTERS, INC
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Mailing Information
Address1: PO BOX 82969
Address2:  
City: TAMPA
State: FL
PostalCode: 336822969
CountryCode: US
TelephoneNumber: 8138660930
FaxNumber: 8134053722
Practice Location
Address1: 1212 E BEARSS AVE
Address2:  
City: LUTZ
State: FL
PostalCode: 33549
CountryCode: US
TelephoneNumber: 8133975300
FaxNumber: 8134053722
Other Information
ProviderEnumerationDate: 08/06/2021
LastUpdateDate: 08/06/2021
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AuthorizedOfficialLastName: HOBACK
AuthorizedOfficialFirstName: SHERRY
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AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 8138660930
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IsOrganizationSubpart: N
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NPICertificationDate: 07/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208D00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansGeneral Practice 

No ID Information.


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