Organization Active NPI

Healthy Family Medical Group, LLC

  • Internal Medicine Physician
  • Brandon, FL
National Provider Identifier
1801263983
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ACN415 Issued in FL
Legal business name
HEALTHY FAMILY MEDICAL GROUP, LLC
Practice address
1138 Nikki View Dr
Brandon, FL 33511-4868
Phone
(813) 393-1500
Fax
(813) 393-1501
NPI assigned
Aug 25, 2015
Last updated
Feb 22, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

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

Authorized official

Name
Julia Beresford
Title
Secretary
Phone
(340) 642-3813

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X ACN415 FL Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 94636 FL

Addresses

Primary practice location

1138 Nikki View Dr
Brandon, FL 33511-4868

Mailing address

PO Box 891293
Tampa, FL 33689-1100
Phone (813) 393-1500

National Provider Directory

National Provider Directory

Locations

1138 Nikki View Dr
Brandon, FL 33511
Phone (813) 393-1500

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": "1440460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456099200000",
    "number": "1801263983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 891293",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336891100",
            "telephone_number": "813-393-1500",
            "fax_number": "813-393-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 NIKKI VIEW DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114868",
            "telephone_number": "813-393-1500",
            "fax_number": "813-393-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY FAMILY MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-25",
        "last_updated": "2016-02-22",
        "status": "A",
        "authorized_official_last_name": "BERESFORD",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "340-642-3813"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ACN415",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "94636",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; 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.