MEDICARE: TAMPA FAMILY HEALTH CENTERS 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
1	261QF0400X	Federally Qualified Health Center (FQHC)	N/A	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1417953571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMPA FAMILY HEALTH CENTERS INC

Provider Business Mailing Address
First Line	:	PO BOX 82969
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33682-2969
Country	:	US
Telephone Number	:	813-866-0930
Fax Number	:	813-866-0929

Provider Business Practice Location Address
First Line	:	12410 N. NEBRASKA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-5416
Country	:	US
Telephone Number	:	813-866-0930
Fax Number	:	813-866-0929

Authorized Official
Title or Position	:	CEO
Name	:	SHERRY HOBACK
Credential	:
Telephone Number	:	813-866-0930

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	04/14/2023

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