Healthcare Provider Details

I. General information

NPI: 1164197034
Provider Name (Legal Business Name): TAMPA GENERAL PROVIDER NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2021
Last Update Date: 08/17/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N OLIVE AVE
WEST PALM BEACH FL
33401-3515
US

IV. Provider business mailing address

PO BOX 95000-7370
PHILADELPHIA PA
19195-7370
US

V. Phone/Fax

Practice location:
  • Phone: 561-655-4334
  • Fax:
Mailing address:
  • Phone: 855-235-3496
  • Fax: 813-724-3198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

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