MEDICARE: LILLIAN INGRAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QP2300X	Primary Care Clinic/Center
2	363LF0000X	Family Nurse Practitioner
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

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

General Provider Information

NPI Number	:	1578146171
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LILLIAN INGRAM

Provider Business Mailing Address
First Line	:	1211 TECH BLVD STE 105
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-7846
Country	:	US
Telephone Number	:	813-999-1516
Fax Number	:	813-336-8384

Provider Business Practice Location Address
First Line	:	1211 TECH BLVD STE 105
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-7846
Country	:	US
Telephone Number	:	813-999-1516
Fax Number	:	813-336-8384

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	LILLIAN E INGRAM
Credential	:	NP
Telephone Number	:	608-217-6108

Provider Enumeration Date	:	04/30/2021
Last Update Date	:	02/16/2022

Similar Medicare Providers

1942564711 — LILLIAN INGRAM
Practice Location Address:

1211 TECH BLVD STE 105
TAMPA, FL
33619-7846

Practice Phone: 813-999-1516
Practice Fax: 813-336-8384

1104174093 — JANICE PEREZ RIVERA LMHC
Practice Location Address:

1211 TECH BLVD
TAMPA, FL
33619-7846

Practice Phone: 813-708-7869
Practice Fax:

1376970491 — KIANA GADSON LCSW
Practice Location Address:

1211 TECH BLVD
TAMPA, FL
33619-7846

Practice Phone: 813-708-7869
Practice Fax:

1265065924 — AFFORDABLE PORTABLE ULTRASOUND LLP
Practice Location Address:

1211 TECH BLVD STE 114
TAMPA, FL
33619-7846

Practice Phone: 813-549-7820
Practice Fax: 813-549-7823

1992391049 — FAVOR HOME CARE SERVICES LLC
Practice Location Address:

1211 TECH BLVD STE 122
TAMPA, FL
33619-7846

Practice Phone: 832-228-7723
Practice Fax:

1356920755 — CATRINA M. HARR
Practice Location Address:

1211 TECH BLVD STE 121
TAMPA, FL
33619-7846

Practice Phone: 863-800-0365
Practice Fax:

Directions to “LILLIAN INGRAM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.