Baycare Medical Group Pediatric Walk-in, LLC

Organization Active NPI Pediatrics Physician · Tampa, FL

NPI 1679724488 · NPPES record last updated Jan 6, 2017

Key facts

NPI
1679724488
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
BAYCARE MEDICAL GROUP PEDIATRIC WALK-IN, LLC
Practice address
4902 Eisenhower Blvd
Suite 300
Tampa, FL 33634-6310
Phone
(813) 636-2044
Fax
(813) 321-6998
NPI assigned
Oct 10, 2008
Organization subpart
Yes
Parent organization (as reported)
BAYCARE MEDICAL GROUP, INC

Authorized official

Name
Mr. Tommy Inzena
Title
President/Ceo
Phone
(813) 636-2044

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 159

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 159

National Provider Directory

Tax ID family
Baycare Medical Group Pediatric Walk-in Care LLC (2 organizations share this tax ID)
Part of
Jeffrey Jsourbeer MD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Pediatrics Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208000000X Yes

Addresses

Primary practice location

4902 Eisenhower Blvd
Suite 300
Tampa, FL 33634-6310

Mailing address

PO Box 743409
Atlanta, GA 30374-3409
Phone (727) 532-0002

Other providers in Tampa, FL

All providers in Tampa, FL · Pediatrics Physician in Florida

Sources for this page

Verify at the official NPI Registry.