Healthcare Provider Details

I. General information

NPI: 1063151413
Provider Name (Legal Business Name): TAMPA GENERAL PROVIDER NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3893 MILITARY TRL STE 1
JUPITER FL
33458-2936
US

IV. Provider business mailing address

PO BOX 95000-7370
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 561-462-3111
  • Fax: 561-462-3221
Mailing address:
  • Phone: 855-235-3496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

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