Provider Demographics
NPI:1730567934
Name:TAMPA FAMILY MEDICAL CENTER, INC
Entity type:Organization
Organization Name:TAMPA FAMILY MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:YUMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMENATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-892-4214
Mailing Address - Street 1:7331 BROOKVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-2925
Mailing Address - Country:US
Mailing Address - Phone:813-892-4214
Mailing Address - Fax:
Practice Address - Street 1:8313 W HILLSBOROUGH AVE STE 210-220
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3816
Practice Address - Country:US
Practice Address - Phone:813-885-4030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10344261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center