Basic Information
| Provider Information | |||||||||
| NPI: | 1639143506 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARMSTRONG | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3000 MEDICAL PARK DR STE 320 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336134681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139100027 | ||||||||
| FaxNumber: | 8139711286 | ||||||||
| Practice Location | |||||||||
| Address1: | 3000 MEDICAL PARK DR STE 320 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336134681 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8139100027 | ||||||||
| FaxNumber: | 8139711286 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2006 | ||||||||
| LastUpdateDate: | 02/07/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | E-2739 | AR | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 2086S0129X | 98-00450 | NC | N | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery | 2086S0129X | OS 9982 | FL | Y | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
ID Information
| ID | Type | State | Issuer | Description | 277579400 | 05 | FL | MEDICAID | 92842 | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER |