Healthcare Provider Details

I. General information

NPI: 1558090928
Provider Name (Legal Business Name): TAMPA GENERAL PROVIDER NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5350 ATLANTIC AVE STE 102
DELRAY BEACH FL
33484-8112
US

IV. Provider business mailing address

PO BOX 95000-7370
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 561-496-4444
  • Fax:
Mailing address:
  • Phone: 855-235-3496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: ABRAHAM B SCHWARZBERG
Title or Position: VP
Credential: MD
Phone: 561-253-3980