Provider Demographics
NPI:1801321625
Name:NORTH TAMPA TMS LLC
Entity type:Organization
Organization Name:NORTH TAMPA TMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:O
Authorized Official - Last Name:SPOONER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:813-992-7867
Mailing Address - Street 1:3010 E 138TH AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3904
Mailing Address - Country:US
Mailing Address - Phone:813-992-7867
Mailing Address - Fax:
Practice Address - Street 1:704 HUXLEY PL
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5428
Practice Address - Country:US
Practice Address - Phone:813-634-9396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-30
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health