Healthcare Provider Details

I. General information

NPI: 1154184588
Provider Name (Legal Business Name): TROUPE HEALTH MEDICAL GROUP, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2024
Last Update Date: 01/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3918 S KINGS AVE
BRANDON FL
33511-7749
US

IV. Provider business mailing address

85 5TH AVE FL 8
NEW YORK NY
10003-3019
US

V. Phone/Fax

Practice location:
  • Phone: 813-603-2061
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HOLLY HRABIK
Title or Position: HEAD OF CLINICAL OPERATIONS
Credential:
Phone: 913-669-3321