NPIMap

Organization Active NPI

Total Vitality Medical Group

  • Non-Pharmacy Dispensing Site
  • Tampa, FL
National Provider Identifier
1154700276
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
ME17577 Issued in FL
Legal business name
TOTAL VITALITY MEDICAL GROUP
Practice address
4100 W Kennedy Blvd
Suite 114
Tampa, FL 33609-2288
Phone
(813) 283-1910
NPI assigned
May 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Authorized official

Name
David Wolstein, M.D
Title
Dispensing Practitoner
Phone
(813) 283-1910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X ME17577 FL Primary

Addresses

Primary practice location

4100 W Kennedy Blvd
Suite 114
Tampa, FL 33609-2288

Mailing address

311 Park Place Blvd
Clearwater, FL 33759-4904
Phone (813) 867-7201

National Provider Directory

National Provider Directory
Tax ID family
Team Mua4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

311 Park Place Blvd
Clearwater, FL 33759

NPI Registry JSON

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1154700276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PARK PLACE BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594904",
            "telephone_number": "813-867-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W KENNEDY BLVD",
            "address_2": "SUITE 114",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336092288",
            "telephone_number": "813-283-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL VITALITY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-21",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "WOLSTEIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DISPENSING PRACTITONER",
        "authorized_official_telephone_number": "813-283-1910",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "ME17577",
            "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 Mar 1, 2023; 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.