Florida Medical Practice

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

FLORIDA MEDICAL PRACTICE

Practice address

19007 Bruce B. Downs Blvd.
Tampa, FL 33647

Phone

(813) 907-0233

Fax

(813) 907-0064

NPI assigned

May 25, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Gautham Sampath, ADMINISTRATION

Title

Administrator

Phone

(813) 907-0233

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1274745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274745600000",
    "number": "1811216286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19007 BRUCE B. DOWNS BLVD.",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33647",
            "telephone_number": "813-907-0233",
            "fax_number": "813-907-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19007 BRUCE B. DOWNS BLVD.",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33647",
            "telephone_number": "813-907-0233",
            "fax_number": "813-907-0064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA MEDICAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-25",
        "last_updated": "2010-05-25",
        "status": "A",
        "authorized_official_last_name": "SAMPATH",
        "authorized_official_first_name": "GAUTHAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-907-0233",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATION"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florida Medical Clinic, LLC
• Florida Medical Clinic, LLC
• Florida Medical Clinic, LLC
• Florida Medical Clinic, LLC
• Florida Medical Labs Inc
• Florida Medical Psychology Associates, LLC
• Florida Medical Specialists, LLC
• Florida Mentor II LLC
• Florida Mentor II LLC
• Florida Mobile Med Inc.

• Pediatrics Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; 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.