NPIMap

Organization Active NPI

Breezefast LLC

  • Health Service Clinic/Center
  • Tampa, FL
National Provider Identifier
1548925027
Registry record updated Feb 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
BREEZEFAST LLC
Practice address
3902 Henderson Blvd Ste 208-12
Tampa, FL 33629-5038
Phone
(813) 867-4990
Fax
(813) 773-1176
NPI assigned
Nov 1, 2021
Last updated
Feb 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2022

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

Authorized official

Name
Titi Ogunu, NPNPI 1346600244
Title
Director
Phone
(813) 867-4990

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

3902 Henderson Blvd Ste 208-12
Tampa, FL 33629-5038

Mailing address

3902 Henderson Blvd Ste 208-12
Tampa, FL 33629-5038
Phone (813) 867-4990

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address titiogunu@direct.practicefusion.com Direct

National Provider Directory

National Provider Directory

Locations

3902 Henderson Blvd
Ste 20812
Tampa, FL 33629
Phone (813) 867-4990

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645401600000",
    "number": "1548925027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3902 HENDERSON BLVD STE 208-12",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295038",
            "telephone_number": "813-867-4990",
            "fax_number": "813-773-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 HENDERSON BLVD STE 208-12",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295038",
            "telephone_number": "813-867-4990",
            "fax_number": "813-773-1176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREEZEFAST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A",
        "authorized_official_last_name": "OGUNU",
        "authorized_official_first_name": "TITI",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "813-867-4990",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "titiogunu@direct.practicefusion.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3902 Henderson Blvd Ste 208-12",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336295038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Feb 21, 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.