NPIMap

Organization Active NPI

Comprehensive Colorectal Care PA

  • Colon & Rectal Surgery Physician
  • Tampa, FL
National Provider Identifier
1265535371
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
Legal business name
COMPREHENSIVE COLORECTAL CARE PA
Practice address
4809 N Armenia Ave
Suite 220
Tampa, FL 33603-1447
Phone
(813) 875-2600
Fax
(813) 575-2626
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Dr. Robert James Theobald III, DO
Title
Physician
Phone
(813) 875-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208C00000X Primary

Addresses

Primary practice location

4809 N Armenia Ave
Suite 220
Tampa, FL 33603-1447

Mailing address

PO Box 550748
Jacksonville, FL 32255-0748
Phone (803) 808-8070

National Provider Directory

National Provider Directory

Locations

514 Eichenfeld Dr
Brandon, FL 33511
Phone (813) 358-1568

4809 N Armenia Ave
Ste 220
Tampa, FL 33603
Phone (813) 445-7342

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1265535371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550748",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322550748",
            "telephone_number": "803-808-8070",
            "fax_number": "803-808-8074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4809 N ARMENIA AVE",
            "address_2": "SUITE 220",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336031447",
            "telephone_number": "813-875-2600",
            "fax_number": "813-575-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE COLORECTAL CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "THEOBALD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "813-875-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "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 Jul 23, 2008; 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.