NPIMap

Organization Active NPI

Tampa Healthy Aging, Inc.

  • General Practice Physician
  • Tampa, FL
National Provider Identifier
1881002533
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS 5939 Issued in FL
Legal business name
TAMPA HEALTHY AGING, INC.
Practice address
15417 N Dale Mabry Hwy
Tampa, FL 33618-1822
Phone
(813) 963-7500
NPI assigned
Jul 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Authorized official

Name
Anthony Granell, PH.D., D.O
Title
Owner
Phone
(813) 963-7500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X OS 5939 FL Primary

Addresses

Primary practice location

15417 N Dale Mabry Hwy
Tampa, FL 33618-1822

Mailing address

15417 N Dale Mabry Hwy
Tampa, FL 33618-1822
Phone (813) 963-7500

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1406246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406246400000",
    "number": "1881002533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15417 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336181822",
            "telephone_number": "813-963-7500",
            "fax_number": "813-963-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15417 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336181822",
            "telephone_number": "813-963-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA HEALTHY AGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-25",
        "status": "A",
        "authorized_official_last_name": "GRANELL",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-963-7500",
        "authorized_official_credential": "PH.D., D.O"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS 5939",
            "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 Jul 25, 2014; 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.