Healthcare Provider Details

I. General information

NPI: 1548348469
Provider Name (Legal Business Name): TAMPA MEDICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 N HABANA AVE SUITE 201
TAMPA FL
33614-7117
US

IV. Provider business mailing address

4700 N HABANA AVE SUITE 201
TAMPA FL
33614-7117
US

V. Phone/Fax

Practice location:
  • Phone: 813-879-5485
  • Fax: 813-871-6141
Mailing address:
  • Phone: 813-879-5485
  • Fax: 813-871-6141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. JOEL CHARLES SILVERFIELD
Title or Position: PRESIDENT
Credential: MD
Phone: 813-879-4585