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NPI Code Detail

MEDICARE: TATIA GRANT LEVY DO

MEDICARE: TATIA GRANT LEVY DO
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
1207P00000XEmergency Medicine PhysicianOS7331FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
278698OTHERFLBCBS
3P00041157OTHERFLRRMCR
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215923511
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATIA GRANT LEVY DO
Provider Business Mailing Address
First Line : 12479 TELECOM DR
Second Line :
City : TAMPA
State : FL
Zip : 33637-0913
Country : US
Telephone Number : 813-972-4199
Fax Number : 813-972-5753
Provider Business Practice Location Address
First Line : 3100 E FLETCHER AVE
Second Line : EMERGENCY DEPT
City : TAMPA
State : FL
Zip : 33613-4613
Country : US
Telephone Number : 813-971-6000
Fax Number : 813-615-7590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2005
Last Update Date : 12/31/2014

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Directions to “ TATIA GRANT LEVY DO” Practice Location

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