Provider Demographics
NPI:1528608155
Name:NORTH TAMPA PHYSICIAN ASSOCIATES LLC
Entity type:Organization
Organization Name:NORTH TAMPA PHYSICIAN ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:IHAB
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRAKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-871-0992
Mailing Address - Street 1:18130 LONGWATER RUN DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2211
Mailing Address - Country:US
Mailing Address - Phone:352-871-0992
Mailing Address - Fax:
Practice Address - Street 1:5196 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-1802
Practice Address - Country:US
Practice Address - Phone:352-871-0992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-11
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty