NPIMap

Organization Active NPI

Essential Integrative Medicine LLC

  • General Practice Physician
  • Tampa, FL
National Provider Identifier
1134470255
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS10332 Issued in FL
Legal business name
ESSENTIAL INTEGRATIVE MEDICINE LLC
Practice address
3715 W Azeele St
Tampa, FL 33609-2807
Phone
(813) 253-0711
Fax
(813) 253-0411
NPI assigned
Sep 28, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Authorized official

Name
Dr. Tan Thang Tran, D.C.NPI 1669590311
Title
President
Phone
(813) 253-0711

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X ME 84580 FL
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X OS10332 FL Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X PA 9104287 FL

Addresses

Primary practice location

3715 W Azeele St
Tampa, FL 33609-2807

Mailing address

3715 W Azeele St
Tampa, FL 33609-2807
Phone (813) 253-0711

National Provider Directory

National Provider Directory

Locations

3715 W Azeele St
Tampa, FL 33609
Phone (813) 253-0711

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1134470255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 W AZEELE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092807",
            "telephone_number": "813-253-0711",
            "fax_number": "813-253-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 W AZEELE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092807",
            "telephone_number": "813-253-0711",
            "fax_number": "813-253-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL INTEGRATIVE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-28",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "TAN",
        "authorized_official_middle_name": "THANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-253-0711",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME 84580",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS10332",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "PA 9104287",
            "primary": false
        }
    ],
    "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 Mar 12, 2015; 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.