Healthcare Provider Details

I. General information

NPI: 1851065338
Provider Name (Legal Business Name): TAMPA FAMILY HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 08/06/2021
Certification Date: 08/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7814 N DALE MABRY HWY
TAMPA FL
33614-3220
US

IV. Provider business mailing address

PO BOX 82969
TAMPA FL
33682-2969
US

V. Phone/Fax

Practice location:
  • Phone: 813-397-5300
  • Fax: 813-405-3938
Mailing address:
  • Phone: 813-866-0930
  • Fax: 813-405-3722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: WENDY HOEFLICH
Title or Position: CFO
Credential:
Phone: 813-599-6188