Citrus Park Medical Care Inc

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

ME50876 Issued in FL

Legal business name

CITRUS PARK MEDICAL CARE INC

Practice address

6328 Gunn Hwy
Tampa, FL 33625-4122

Phone

(813) 964-8526

Fax

(813) 964-8536

NPI assigned

Jan 4, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dipak Shah, MDNPI 1295703064

Title

Owner

Phone

(813) 265-2066

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Citrus Park Medical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Citrus Park Medical

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1134334790
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa Marie Dinard, APRN

  • Nurse Practitioner
  • Tampa, FL
  • NPI 1114225240
  Medicare reassignment NPD
• Renan Wolf, APRN

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1821960667

  Single Specialty

  Medicare reassignment NPD
• Shital R Mehta, D.O.

  • Internal Medicine Physician
  • Wesley Chapel, FL
  • NPI 1861460610
  Medicare reassignment
• Dipak Shah, M.D.

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1295703064
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033266176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6328 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254122",
            "telephone_number": "813-964-8526",
            "fax_number": "813-964-8536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6328 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336254122",
            "telephone_number": "813-964-8526",
            "fax_number": "813-964-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS PARK MEDICAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "DIPAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-265-2066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "FL",
            "license": "ME50876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Citrus Park Eye Center Inc (Citrus Park Eyecare)
• Citrus Park Eyecare Inc
• Citrus Park Family Care LLC
• Citrus Park Internal Medicine (Lake Park Internal Medicne)
• Citrus Park Medical
• Citrus Park Surgery Center
• Citrus-Bay Medical Equipments L.L.C
• City Care Services Inc (City Care Pharmacy)
• City of Tampa Fla
• Citycare Health Inc.

• Legal Medicine in Tampa, FL
• Providers in Tampa, FL by specialty
• Legal Medicine in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.