Active NPI
Prevention 305, Inc
- Infectious Disease Physician
- Tampa, FL
National Provider Identifier
1689447336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- Legal business name
- PREVENTION 305, INC
- Practice address
- 3317 W Gandy Blvd
Tampa, FL 33611-2931 - Phone
- (813) 902-8600
- Fax
- (813) 902-8800
- NPI assigned
- Nov 3, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Patrick Whiteside
- Title
- Chief Executive Officer
- Phone
- (305) 812-8380
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | Primary |
Addresses
Primary practice location
3317 W Gandy Blvd
Tampa, FL 33611-2931
Mailing address
407 Lincoln Rd Ste 6D
Miami Beach, FL 33139-3023
Phone (866) 773-7305
Other names 1
- PREVENTION ACCESS CAMPAIGN
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240416004070 | FL | Part B Supplier - Clinic/Group Practice | 8325487895 |
Receives reassigned benefits from 9 practitioners Practice locations: Orlando, FL; Saint Petersburg, FL; Tampa, FL |
National Provider Directory
National Provider DirectoryLocations
407 Lincoln Rd
Ste 6D
Miami Beach, FL 33139
3317 W Gandy Blvd
#813
Tampa, FL 33611
Phone (813) 902-8600
3317 W Gandy Blvd
Ste 813
Tampa, FL 33611
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Adult Health Nurse Practitioner
- Saint Petersburg, FL
- NPI 1821738287
FL, Multi-Specialty
-
- Psychiatric/Mental Health Nurse Practitioner
- Pittsburgh, PA
- NPI 1740860964
FL
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698969600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1705536000000",
"number": "1689447336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 LINCOLN RD STE 6D",
"city": "MIAMI BEACH",
"state": "FL",
"postal_code": "331393023",
"telephone_number": "866-773-7305",
"fax_number": "352-681-4788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3317 W GANDY BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336112931",
"telephone_number": "813-902-8600",
"fax_number": "813-902-8800"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREVENTION 305, INC",
"organizational_subpart": "NO",
"enumeration_date": "2023-11-03",
"last_updated": "2024-01-18",
"certification_date": "2023-11-15",
"status": "A",
"authorized_official_last_name": "WHITESIDE",
"authorized_official_first_name": "PATRICK",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "305-812-8380"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Infectious Disease",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "PREVENTION ACCESS CAMPAIGN",
"code": "4",
"type": "Former Legal Business Name"
}
]
}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 Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.