Organization Active NPI

Healthyconnect of Florida LLC

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1194528208
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
HEALTHYCONNECT OF FLORIDA LLC
Practice address
4016 Henderson Blvd Ste J
Tampa, FL 33629-4940
Phone
(813) 334-7442
NPI assigned
Apr 1, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Authorized official

Name
Frederick Burris
Title
Cfo
Phone
(813) 334-7442

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4016 Henderson Blvd Ste J
Tampa, FL 33629-4940

Mailing address

4030 Henderson Blvd Ste 598
Tampa, FL 33629-4940

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250910004851 FL Part B Supplier - Clinic/Group Practice 0244733806 Receives reassigned benefits from 1 practitioner
Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

Locations

4016 Henderson Blvd
Ste J
Tampa, FL 33629
Phone (813) 334-7442

Practitioners & affiliated clinicians

Practitioners 1

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": "1743465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775088000000",
    "number": "1194528208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 HENDERSON BLVD STE 598",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336294940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 HENDERSON BLVD STE J",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336294940",
            "telephone_number": "813-334-7442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHYCONNECT OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-01",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A",
        "authorized_official_last_name": "BURRIS",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "813-334-7442"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal 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 Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.