Complete Integrative Medical Clinic, LLC.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

COMPLETE INTEGRATIVE MEDICAL CLINIC, LLC.

Practice address

2835 W de Leon St Ste 102
Tampa, FL 33609-4130

Phone

(813) 374-5584

NPI assigned

Jul 1, 2020

Organization subpart

No

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

Authorized official

Name

Amanda Camp, DNP-NP-C

Title

Owner

Phone

(727) 709-9770

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593561600000",
    "number": "1326665779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 75472",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336750472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 W DE LEON ST STE 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094130",
            "telephone_number": "813-374-5584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE INTEGRATIVE MEDICAL CLINIC, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A",
        "authorized_official_last_name": "CAMP",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-709-9770",
        "authorized_official_credential": "DNP-NP-C"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.