MEDICARE: DR. SYLVIA D CAMPBELL M.D.

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	174400000X	Specialist	ME32624	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	020001834	OTHER		RR MCR ID #
3	33660	OTHER		GHI ID #
4	30483	OTHER	DC	BCBS ID #
5	592316341	OTHER		FEDERAL TAX ID

General Provider Information

NPI Number	:	1194774513
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SYLVIA D CAMPBELL M.D.

Provider Business Mailing Address
First Line	:	217 S MATANZAS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3010
Country	:	US
Telephone Number	:	813-875-2655
Fax Number	:	813-872-1838

Provider Business Practice Location Address
First Line	:	217 S MATANZAS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-3010
Country	:	US
Telephone Number	:	813-875-2655
Fax Number	:	813-872-1838

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	03/07/2023

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