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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1124426176
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	:	6488 N US HIGHWAY 41
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-1804
Country	:	US
Telephone Number	:	813-844-7500
Fax Number	:	813-844-1141

Authorized Official
Title or Position	:	CHIEF MEDICAL INFORMATICS OFFICER
Name	:	DR. PETER T CHANG
Credential	:	M.D.
Telephone Number	:	813-844-3956

Provider Enumeration Date	:	12/08/2014
Last Update Date	:	12/19/2025

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