Healthcare Provider Details

I. General information

NPI: 1881145407
Provider Name (Legal Business Name): U.S. HEALTHWORKS MEDICAL GROUP OF FLORIDA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2016
Last Update Date: 10/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5406 HOOVER BLVD STE 21
TAMPA FL
33634-5330
US

IV. Provider business mailing address

25124 SPRINGFIELD CT 200
VALENCIA CA
91355-1085
US

V. Phone/Fax

Practice location:
  • Phone: 813-247-4489
  • Fax: 813-247-4480
Mailing address:
  • Phone: 661-678-2600
  • Fax: 661-678-2700

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH MALLAS
Title or Position: PRESIDENT
Credential:
Phone: 661-678-2626