Healthcare Provider Details

I. General information

NPI: 1376477943
Provider Name (Legal Business Name): TAMPA FAMILY HEALTH CENTERS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 E FLETCHER AVE STE 130
TAMPA FL
33613-4678
US

IV. Provider business mailing address

302 W FLETCHER AVE
TAMPA FL
33612-3415
US

V. Phone/Fax

Practice location:
  • Phone: 813-397-5300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MS. STACY M PAGAN
Title or Position: VP, REVENUE CYCLE MANAGEMENT
Credential:
Phone: 813-730-3268