NPIMap

Organization Active NPI

Physician Enterprises PL

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Tampa, FL
National Provider Identifier
1306132527
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
ME41814 Issued in FL
Legal business name
PHYSICIAN ENTERPRISES PL
Practice address
3007 W Fair Oaks Ave
Tampa, FL 33611-1640
Phone
(813) 839-6299
Fax
(813) 839-4939
NPI assigned
Jun 27, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Authorized official

Name
Dr. John C Brock, MD
Title
Managing Member
Phone
(813) 839-6299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X ME41814 FL Primary

Addresses

Primary practice location

3007 W Fair Oaks Ave
Tampa, FL 33611-1640

Mailing address

3007 W Fair Oaks Ave
Tampa, FL 33611-1640
Phone (813) 839-6299

Other identifiers 1

IdentifierTypeStateIssuer
ME41814OtherMEDICAL LICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309132800000",
    "number": "1306132527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 W FAIR OAKS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336111640",
            "telephone_number": "813-839-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 W FAIR OAKS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336111640",
            "telephone_number": "813-839-6299",
            "fax_number": "813-839-4939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN ENTERPRISES PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-27",
        "last_updated": "2011-06-27",
        "status": "A",
        "authorized_official_last_name": "BROCK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "813-839-6299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "ME41814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME41814",
            "state": null
        }
    ],
    "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 Jun 27, 2011; 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.