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General NPI Number Information
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NPI Number | 1215889852
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC MEDICAL GROUP OF TAMPA BAY PA
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Dates
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Enumeration Date | 02/13/2026
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 7239 PARADISO DR
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City | APOLLO BEACH
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State | FL
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Zip | 33572
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Country | US
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Telephone | 813-684-2663
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Fax | 813-658-6222
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Provider Business Mailing Address
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Address Line | 7239 PARADISO DR
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City | APOLLO BEACH
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State | FL
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Zip | 33572
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Country | US
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Telephone | 813-684-2663
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Fax | 813-658-6222
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | TARYN REID
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Credential |
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Telephone | 813-534-0102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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