Healthcare Provider Details

I. General information

NPI: 1871320408
Provider Name (Legal Business Name): TAMPA GENERAL PROVIDER NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 09/17/2024
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 N FLAGLER DR STE 5600
WEST PALM BEACH FL
33401-3412
US

IV. Provider business mailing address

PO BOX 95000-7370
PHILADELPHIA PA
19195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 561-659-6543
  • Fax: 561-659-3533
Mailing address:
  • Phone: 561-659-6543
  • Fax: 561-659-3533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: ABRAHAM B SCHWARZBERG
Title or Position: PRESIDENT
Credential: MD
Phone: 561-253-3980