Organization Active NPI

Mdside

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1861298218
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MDSIDE
Practice address
109 N 12TH St Ste 1105
Tampa, FL 33602-3686
Phone
(813) 808-3142
Fax
(813) 591-4522
NPI assigned
Feb 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Dr. Victor Damaso Cruz, MDNPI 1861622060
Title
Managing Member
Phone
(813) 808-3142

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

109 N 12TH St Ste 1105
Tampa, FL 33602-3686

Mailing address

401 E Jackson St Ste 2340-K14
Tampa, FL 33602-5233
Phone (800) 579-6971

National Provider Directory

National Provider Directory

Locations

401 E Jackson St
Ste 2340K14
Tampa, FL 33602

109 N 12th St
Ste 1105
Tampa, FL 33602
Phone (813) 808-3142

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1861298218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E JACKSON ST STE 2340-K14",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025233",
            "telephone_number": "800-579-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N 12TH ST STE 1105",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336023686",
            "telephone_number": "813-808-3142",
            "fax_number": "813-591-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDSIDE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "DAMASO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "813-808-3142",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 24, 2025; 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.