Individual provider Active NPI

Milton Dris

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1144635798
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW-XXXX Issued in FL
Practice address
3825 Henderson Blvd
Suite 405
Tampa, FL 33629-5037
Phone
(727) 403-2777
Fax
(813) 443-2587
NPI assigned
Jun 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X ISW-XXXX FL Primary

Addresses

Primary practice location

3825 Henderson Blvd
Suite 405
Tampa, FL 33629-5037

Mailing address

3825 Henderson Blvd
Suite 405
Tampa, FL 33629-5037
Phone (727) 403-2777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ISW-XXXXFLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403481600000",
    "number": "1144635798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 HENDERSON BLVD",
            "address_2": "SUITE 405",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295037",
            "telephone_number": "727-403-2777",
            "fax_number": "813-443-2587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 HENDERSON BLVD",
            "address_2": "SUITE 405",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295037",
            "telephone_number": "727-403-2777",
            "fax_number": "813-443-2587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRIS",
        "first_name": "MILTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW-XXXX",
            "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 Jun 23, 2014; 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.