NPIMap

Organization Active NPI

Carrollwood Emergency Physicians PA

  • Emergency Medicine Physician
  • Tampa, FL
National Provider Identifier
1215988829
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
CARROLLWOOD EMERGENCY PHYSICIANS PA
Practice address
7171 N Dale Mabry Hwy
Tampa, FL 33614-2630
Phone
(813) 932-2222
Fax
(813) 972-5753
NPI assigned
May 16, 2006
Last updated
Nov 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Authorized official

Name
Dr. Andre R Landreville, MD
Title
Chief Operating Officer
Phone
(813) 972-4199

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

7171 N Dale Mabry Hwy
Tampa, FL 33614-2630

Mailing address

12479 Telecom Dr
Tampa, FL 33637-0913
Phone (813) 972-4199

Other identifiers 1

IdentifierTypeStateIssuer
24275OtherFLBCBS OF FLORIDA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 51

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 51

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193875200000",
    "number": "1215988829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12479 TELECOM DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336370913",
            "telephone_number": "813-972-4199",
            "fax_number": "813-972-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7171 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142630",
            "telephone_number": "813-932-2222",
            "fax_number": "813-972-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLLWOOD EMERGENCY PHYSICIANS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2007-11-01",
        "status": "A",
        "authorized_official_last_name": "LANDREVILLE",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "813-972-4199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "24275",
            "state": "FL"
        }
    ],
    "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 Nov 1, 2007; 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.