Healthcare Provider Details

I. General information

NPI: 1497969174
Provider Name (Legal Business Name): HEALTHPOINT MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 09/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 W DR MARTIN LUTHER KING JR BLVD 3RD FLOOR
TAMPA FL
33607-6307
US

IV. Provider business mailing address

4902 EISENHOWER BLVD SUITE 300
TAMPA FL
33634-6344
US

V. Phone/Fax

Practice location:
  • Phone: 813-554-8384
  • Fax: 813-554-8992
Mailing address:
  • Phone: 813-636-2000
  • Fax: 813-636-2050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: SHERRY DORSEY
Title or Position: CORPORATE OFFICE-AUTHORIZED AGENT
Credential:
Phone: 813-636-2000