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NPI Code Detail

MEDICARE: TAMPA GENERAL MEDICAL GROUP INC

MEDICARE: TAMPA GENERAL MEDICAL GROUP INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician
2207RE0101XEndocrinology, Diabetes & Metabolism Physician
3207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073064127
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAMPA GENERAL MEDICAL GROUP INC
Provider Business Mailing Address
First Line : PO BOX 1289
Second Line :
City : TAMPA
State : FL
Zip : 33601-1289
Country : US
Telephone Number : 813-844-3956
Fax Number : 813-844-4712
Provider Business Practice Location Address
First Line : 10740 PALM RIVER ROAD
Second Line : STE 360
City : TAMPA
State : FL
Zip : 33619
Country : US
Telephone Number : 813-660-6000
Fax Number :
Authorized Official
Title or Position : CHIEF MEDICAL INFORMATICS OFFICER
Name : DR. PETER CHANG
Credential : M.D.
Telephone Number : 813-844-3956
Provider Enumeration Date : 10/24/2016
Last Update Date : 12/22/2025

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Directions to “TAMPA GENERAL MEDICAL GROUP INC ” Practice Location

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