NPIMap

Organization Active NPI

South Tampa Medical Associates Inc

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1114258043
Registry record updated Jan 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS0003135 Issued in FL
Legal business name
SOUTH TAMPA MEDICAL ASSOCIATES INC
Practice address
3614 W Kennedy Blvd
Suite B
Tampa, FL 33609-2852
Phone
(813) 890-8004
Fax
(813) 290-9691
NPI assigned
Jan 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2010

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

Authorized official

Name
Leonard Mennen, MDNPI 1518916287
Title
Physician
Phone
(813) 890-8004

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X OS0003135 FL Primary

Addresses

Primary practice location

3614 W Kennedy Blvd
Suite B
Tampa, FL 33609-2852

Mailing address

3614 W Kennedy Blvd
Suite B
Tampa, FL 33609-2852
Phone (813) 890-8004

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263513600000",
    "number": "1114258043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3614 W KENNEDY BLVD",
            "address_2": "SUITE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092852",
            "telephone_number": "813-890-8004",
            "fax_number": "813-290-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 W KENNEDY BLVD",
            "address_2": "SUITE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092852",
            "telephone_number": "813-890-8004",
            "fax_number": "813-290-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TAMPA MEDICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-15",
        "last_updated": "2010-01-15",
        "status": "A",
        "authorized_official_last_name": "MENNEN",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "813-890-8004",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS0003135",
            "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 Jan 15, 2010; 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.