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NPI Code Detail

MEDICARE: ALL MEDICAL GROUP OF TAMPA BAY,LLC

MEDICARE: ALL MEDICAL GROUP OF TAMPA BAY,LLC
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
1305R00000XPreferred Provider Organization

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 : 1881063436
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALL MEDICAL GROUP OF TAMPA BAY,LLC
Provider Business Mailing Address
First Line : 3413 S KINGS AVE
Second Line :
City : BRANDON
State : FL
Zip : 33511-7780
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3413 S KINGS AVE
Second Line :
City : BRANDON
State : FL
Zip : 33511-7780
Country : US
Telephone Number : 888-888-8888
Fax Number :
Authorized Official
Title or Position : O
Name : S S
Credential : M.D
Telephone Number : 813-765-1930
Provider Enumeration Date : 09/24/2015
Last Update Date : 01/26/2016

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Directions to “ALL MEDICAL GROUP OF TAMPA BAY,LLC ” Practice Location

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