Organization Active NPI

Blessedcare Center, Inc

  • Geriatric Medicine (Internal Medicine) Physician
  • Tampa, FL
National Provider Identifier
1104308170
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
BLESSEDCARE CENTER, INC
Practice address
4710 N Habana Ave Ste 402
Tampa, FL 33614-7152
Phone
(813) 304-1299
Fax
(813) 304-1423
NPI assigned
Sep 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Authorized official

Name
Dr. Carlos Alberto Salazar, MDNPI 1215900931
Title
MD
Phone
(813) 751-7557

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

4710 N Habana Ave Ste 402
Tampa, FL 33614-7152

Mailing address

4710 N Habana Ave Ste 402
Tampa, FL 33614-7152
Phone (813) 304-1299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190205001242 FL Part B Supplier - Clinic/Group Practice 6608114327 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2150858Blessedcare Center, Inc4710 N Habana Ave Ste 402, Tampa, FL 33614Certificate of waiverJul 5, 2028

National Provider Directory

National Provider Directory

Locations

4710 N Habana Ave
Ste 402
Tampa, FL 33614
Phone (813) 304-1299

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536105600000",
    "number": "1104308170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 N HABANA AVE STE 402",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147152",
            "telephone_number": "813-304-1299",
            "fax_number": "813-304-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 N HABANA AVE STE 402",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147152",
            "telephone_number": "813-304-1299",
            "fax_number": "813-304-1423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLESSEDCARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-05",
        "last_updated": "2018-09-05",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "813-751-7557",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.