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NPI Code Detail

MEDICARE: TAMPA GENERAL MEDICAL GROUP INC

MEDICARE: TAMPA GENERAL MEDICAL GROUP INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RX0202XMedical Oncology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205479862
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAMPA GENERAL MEDICAL GROUP INC
Provider Business Mailing Address
First Line : PO BOX 1289
Second Line :
City : TAMPA
State : FL
Zip : 33601-1289
Country : US
Telephone Number : 813-844-3956
Fax Number :
Provider Business Practice Location Address
First Line : 10740 PALM RIVER RD STE 360
Second Line :
City : TAMPA
State : FL
Zip : 33619-4578
Country : US
Telephone Number : 813-660-6400
Fax Number :
Authorized Official
Title or Position : VP CARE TRANSITIONS
Name : PETER TRAVIS RIAD CHANG
Credential :
Telephone Number : 813-844-3956
Provider Enumeration Date : 10/25/2019
Last Update Date : 12/23/2025

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