Ideal Body Institute Tampa, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

IDEAL BODY INSTITUTE TAMPA, LLC

Practice address

5931 Webb Rd
Tampa, FL 33615-3219

Phone

(678) 466-6760

NPI assigned

Apr 12, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Ibikunle, MD

Title

Cio

Phone

(678) 466-6760

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649721600000",
    "number": "1376285106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 ATHENS HWY STE 100",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522207",
            "telephone_number": "678-466-6760",
            "fax_number": "678-802-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5931 WEBB RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336153219",
            "telephone_number": "678-466-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL BODY INSTITUTE TAMPA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A",
        "authorized_official_last_name": "IBIKUNLE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CIO",
        "authorized_official_telephone_number": "678-466-6760",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.