MEDICARE: TAMPA HEIGHTS MEDICAL CENTER LLC

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	ME74147	FL

General Provider Information

NPI Number	:	1346490356
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAMPA HEIGHTS MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	PO BOX 172266
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33672-0266
Country	:	US
Telephone Number	:	813-874-2642
Fax Number	:

Provider Business Practice Location Address
First Line	:	4144 N ARMENIA AVE STE 210
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6447
Country	:	US
Telephone Number	:	813-872-8600
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. FAITH FELDER
Credential	:	MD
Telephone Number	:	813-872-8600

Provider Enumeration Date	:	09/26/2008
Last Update Date	:	12/03/2018

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