Active NPI
Healthyconnect of Florida LLC
- Internal Medicine Physician
- Tampa, FL
National Provider Identifier
1194528208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 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
National Provider Directory
National Provider DirectoryLocations
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.