TAMPA TRAUMA MEDICAL CENTER (NPI# 1063550481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063550481 |
| Entity Type | Organization |
| Organization Name | TAMPA TRAUMA MEDICAL CENTER |
| Other Organization Name | TAMPA TRAUMA MEDICAL CENTER |
| Practice Address |
4602 N Armenia Ave Suite D1 Tampa FL 33603-2626 |
| Practice Telephone | 8138701900 |
| Practice Fax Number | 8138701988 |
| Mailing Telephone | 8138701900 |
| Mailing Fax Number | 8138701988 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LUIS M AZAN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8138701900 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | HCC6118 | FL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| TAMPA TRAUMA MEDICAL CENTER | Former Legal Business Name - Organization |
| Street Address |
4602 N ARMENIA AVE SUITE D1 |
| City | TAMPA |
| State | FL |
| Zip Code | 33603-2626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992727937 | Tampa Health Care Supplies | Durable Medical Equipment & Medical Supplies | 4602 N Armenia Ave, Suite D 2, Tampa, FL 33603-2626 | 2006-07-25 |
| 1558898957 | Christina A Moreno | Chiropractor | 4602 N Armenia Ave, Tampa, FL 33603-2626 | 2017-05-16 |
| 1538415104 | Karen Ann Bebnowski | Counselor | 4602 N Armenia Ave, #c, Tampa, FL 33603-2626 | 2012-08-01 |
| 1659676633 | Michelle Y Doers | Respiratory Therapist, Registered | 4602 N Armenia Ave, C, Tampa, FL 33603-2626 | 2011-01-21 |
| 1568765147 | Alexis Remedios | Massage Therapist | 4602 N Armenia Ave, Suite B-3, Tampa, FL 33603-2626 | 2010-12-21 |
| 1760784490 | Krystal A Larsen | Behavioral Analyst | 4602 N Armenia Ave, C, Tampa, FL 33603-2626 | 2010-12-01 |
| 1376856344 | Jennifer L Doherty | Behavioral Analyst | 4602 N Armenia Ave, Suite C, Tampa, FL 33603-2626 | 2010-07-20 |
| 1831411073 | Joshua Lee Otiniano | Chiropractor | 4602 N Armenia Ave, Suite B-4/ B-5, Tampa, FL 33603-2626 | 2010-02-15 |
| 1861726796 | Heather L Burris | Behavioral Analyst | 4602 N Armenia Ave, Tampa, FL 33603-2626 | 2009-09-24 |
| 1184861148 | Outpatient Pain & Wellness Center, Inc. | Chiropractor | 4602 N Armenia Ave, Suite B5, Tampa, FL 33603-2626 | 2009-01-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700400959 | Jean V. Dieudonne | Pharmacist | 701 W. Dr Martin Luther King Blvd, Tampa, FL 33603 | 2020-06-03 |
| 1538791082 | Champion Wellness Center of The Heights | Chiropractor | 800 W Martin Luther King Jr Blvd, Suite 3, Tampa, FL 33603 | 2020-02-12 |
| 1700366010 | Marie A Brister Md LLC | Family Medicine | 508 W Dr Martin Luther King Jr Blvd Ste A, Tampa, FL 33603 | 2018-08-16 |
| 1619415197 | Riverside Recovery of Tampa, LLC | Substance Abuse Rehabilitation Facility | 4004 N. Riverside Dr., Tampa, FL 33603 | 2017-02-06 |
| 1306213194 | Jacqueline Dowgiallo | Case Manager/Care Coordinator | 4004 N Riverside Dr, Tampa, FL 33603 | 2015-08-27 |
| 1629487061 | Robin Ann Waters | Social Worker | 1016 W Hillsborough Ave, Tampa, FL 33603 | 2014-08-11 |
| 1831430453 | Cassandra Gonzalez | Social Worker | 1726 W Rio Vista Ave, Tampa, FL 33603 | 2013-03-06 |
| 1487908893 | Spine Injury Physicians LLC | Neurological Surgery | 607 W Martin Luther King Blvd, Suite 1, Tampa, FL 33603 | 2012-11-07 |
| 1861742124 | Joseph Timothy Candelore Jr. | Internal Medicine | 2333 W Hillsborough Ave Ste 160, Tampa, FL 33603 | 2012-09-14 |
| 1679835599 | Odessa Biandudi | Dentist | 825 West Martin Luther King Boulevard, Tampa, FL 33603 | 2012-06-15 |
| Find all providers in zip 33603 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679173926 | Haven Medical Center, Inc. | Clinic/Center | 11961 N Florida Ave, Tampa, FL 33612-5213 | 2020-10-27 |
| 1396351110 | Claudia B Gonzalez | Clinic/Center | 7819 N Dale Mabry Hwy Ste 104, Tampa, FL 33614-3210 | 2020-09-17 |
| 1154936904 | El Sol Medical Center Inc | Clinic/Center | 2112 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607-6512 | 2020-09-09 |
| 1689287351 | Tampa Bay Medical Mental & Behavioral Health Services Inc | Clinic/Center | 8910 N Dale Mabry Hwy Ste 17, Tampa, FL 33614-1580 | 2020-08-24 |
| 1801428685 | Primera Health Center Inc | Clinic/Center | 7820 N Armenia Ave Ste A, Tampa, FL 33604-3852 | 2020-02-10 |
| 1295389153 | Tampa Wellness Group LLC | Clinic/Center | 3750 Gunn Hwy Ste 200, Tampa, FL 33618-8916 | 2019-07-30 |
| 1245899954 | Pain Free Acupuncture, LLC | Clinic/Center | 14195 Bruce B Downs Blvd Ste 2, Tampa, FL 33613-3805 | 2019-06-07 |
| 1205337961 | Rogers Memorial Hospital Inc | Clinic/Center | 2002 N Lois Ave Ste 400, Tampa, FL 33607-2394 | 2018-02-27 |
| 1952801581 | Max Health Wellness Corp | Clinic/Center | 6105 Memorial Hwy Ste S, Tampa, FL 33615-4506 | 2018-02-20 |
| 1427569920 | Undersea Oxygen Clinic LLC | Clinic/Center | 701 N West Shore Blvd Fl 3, Tampa, FL 33609-1122 | 2017-10-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.