Healthcare Provider Details

I. General information

NPI: 1821910316
Provider Name (Legal Business Name): TAMPA GENERAL HOSPITAL DESOTO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N ROBERT AVE
ARCADIA FL
34266-8712
US

IV. Provider business mailing address

PO BOX 1289
TAMPA FL
33601-1289
US

V. Phone/Fax

Practice location:
  • Phone: 863-494-3535
  • Fax:
Mailing address:
  • Phone: 813-660-7980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARK RUNYON
Title or Position: CFO
Credential:
Phone: 813-844-4805