Tampa Medical Center LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

TAMPA MEDICAL CENTER LLC

Doing business as

BODZE

Practice address

5535 Memorial Hwy
Tampa, FL 33634-7332

Phone

(813) 474-8342

NPI assigned

Mar 17, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Nisreen Fernandez

Title

Owner

Phone

(813) 474-8342

Specialties & licenses 1

Addresses

Other names 1

• BODZE Doing business as

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1063160174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5535 MEMORIAL HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336347332",
            "telephone_number": "813-474-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 MEMORIAL HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336347332",
            "telephone_number": "813-474-8342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-17",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "NISREEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-474-8342",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BODZE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Plastic and Reconstructive Surgery Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.