Healthcare Provider Details

I. General information

NPI: 1114927027
Provider Name (Legal Business Name): TAMPA MEDICAL CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 01/29/2020
Certification Date: 01/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5106 N ARMENIA AVE STE 4
TAMPA FL
33603-1433
US

IV. Provider business mailing address

5106 N ARMENIA AVE STE 4
TAMPA FL
33603-1433
US

V. Phone/Fax

Practice location:
  • Phone: 813-931-2366
  • Fax: 813-936-8886
Mailing address:
  • Phone: 813-931-2366
  • Fax: 813-936-8886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME0068445
License Number StateFL

VIII. Authorized Official

Name: DR. CHANDRA PRAKASH BAPNA
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 813-931-2366