MEDICARE: TAMPA MEDICAL GROUP

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1184312878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMPA MEDICAL GROUP

Provider Business Mailing Address
First Line	:	5351 BRIDGE ST UNIT 39
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-3425
Country	:	US
Telephone Number	:	813-629-0463
Fax Number	:

Provider Business Practice Location Address
First Line	:	5351 BRIDGE ST UNIT 39
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-3425
Country	:	US
Telephone Number	:	813-629-0463
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. SAM SAMARRAI
Credential	:	MD
Telephone Number	:	813-629-0463

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	05/01/2023

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Directions to “TAMPA MEDICAL GROUP ” Practice Location

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