Marie a Brister MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME118349 Issued in FL

Legal business name

MARIE A BRISTER MD LLC

Practice address

508 W Dr Martin Luther King Jr Blvd Ste a
Tampa, FL 33603

Phone

(813) 229-1924

NPI assigned

Aug 16, 2018

Organization subpart

No

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

Authorized official

Name

Marie Brister, MD

Title

Owner/President

Phone

(813) 229-1924

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1700366010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 W DR MARTIN LUTHER KING JR BLVD STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336033415",
            "telephone_number": "813-229-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 W DR MARTIN LUTHER KING JR BLVD STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33603",
            "telephone_number": "813-229-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIE A BRISTER MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "BRISTER",
        "authorized_official_first_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "813-229-1924",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME118349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.