MEDICARE: BRANCH HEALTH, 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
1	103TB0200X	Cognitive & Behavioral Psychologist

General Provider Information

NPI Number	:	1588558274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRANCH HEALTH, INC.

Provider Business Mailing Address
First Line	:	301 W PLATT ST # 189
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-2292
Country	:	US
Telephone Number	:	319-382-0504
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 W PLATT ST # 189
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-2292
Country	:	US
Telephone Number	:	813-416-9934
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	BOBBY RAZAVI
Credential	:
Telephone Number	:	319-382-0504

Provider Enumeration Date	:	06/06/2025
Last Update Date	:	01/14/2026

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Directions to “BRANCH HEALTH, INC. ” Practice Location

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