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General NPI Number Information
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NPI Number | 1235191362
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Entity Type | Organization
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Legal Business Name | TAMPA BAY INTERNAL MEDICINE INC
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Dates
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Enumeration Date | 04/04/2006
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Last Update Date | 08/26/2011
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Provider Practice Location Address
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Address Line | 1939 HIGHLAND OAKS BLVD
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City | LUTZ
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State | FL
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Zip | 33559-7323
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Country | US
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Telephone | 813-948-1234
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Fax | 813-949-8408
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Provider Business Mailing Address
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Address Line | 1939 HIGHLAND OAKS BLVD
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City | LUTZ
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State | FL
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Zip | 33559-7323
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Country | US
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Telephone | 813-948-1234
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Fax | 813-949-8408
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Authorized Official
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Title or Position | DOCTOR
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Name | MR. JERAMBHAI T KANKOTIA
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Credential | MD
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Telephone | 813-948-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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