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NPI Code Detail

MEDICARE: TAMPA FAMILY HEALTH CENTERS INC

MEDICARE: TAMPA FAMILY HEALTH CENTERS INC
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
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1578857140
Entity Type Code : Organization
Provider Name (Legal Business Name) : TAMPA FAMILY HEALTH CENTERS INC
Provider Business Mailing Address
First Line : PO BOX 82969
Second Line :
City : TAMPA
State : FL
Zip : 33682-2969
Country : US
Telephone Number : 813-866-0930
Fax Number : 813-866-0929
Provider Business Practice Location Address
First Line : 13601 N 22ND ST
Second Line :
City : TAMPA
State : FL
Zip : 33613-4427
Country : US
Telephone Number : 813-307-8058
Fax Number : 813-866-0929
Authorized Official
Title or Position : PRESIDENT/CEO
Name : MR. CHARLES R BOTTOMS
Credential :
Telephone Number : 813-866-0930
Provider Enumeration Date : 06/01/2011
Last Update Date : 11/17/2016

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Directions to “TAMPA FAMILY HEALTH CENTERS INC ” Practice Location

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