Organization Active NPI

Progressive Family Care LLC

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1629885462
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PROGRESSIVE FAMILY CARE LLC
Practice address
4504 Wishart PL
Tampa, FL 33603-2724
Phone
(813) 605-7775
Fax
(813) 605-7160
NPI assigned
Dec 16, 2024
Last updated
Sep 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Michael Smith
Title
President
Phone
(813) 770-2782

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

4504 Wishart PL
Tampa, FL 33603-2724

Mailing address

4504 Wishart PL
Tampa, FL 33603-2724
Phone (813) 605-7775

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2317701Progressive Family Care LLC4504 Wishart PL, Tampa, FL 33603Certificate of waiverJan 29, 2027

National Provider Directory

National Provider Directory

Locations

3550 W Waters Ave
Ste 260
Tampa, FL 33614
Phone (813) 374-0298

Practitioners & affiliated clinicians

Practitioners 3

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": "1734307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1629885462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4504 WISHART PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336032724",
            "telephone_number": "813-605-7775",
            "fax_number": "813-605-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4504 WISHART PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336032724",
            "telephone_number": "813-605-7775",
            "fax_number": "813-605-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-16",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-770-2782"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "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 Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.