TOTAL VITALITY MEDICAL GROUP (NPI# 1154700276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154700276 |
| Entity Type | Organization |
| Organization Name | TOTAL VITALITY MEDICAL GROUP |
| Practice Address |
4100 W Kennedy Blvd Suite 114 Tampa FL 33609-2288 |
| Mailing Address |
311 Park Place Blvd Clearwater FL 33759-4904 |
| Practice Telephone | 8132831910 |
| Mailing Telephone | 8138677201 |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |
| Authorized Official Name | DAVID WOLSTEIN (DISPENSING PRACTITONER) |
| Authorized Official Telephone | 8132831910 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | ME17577 | FL | Suppliers |
| Street Address |
4100 W KENNEDY BLVD SUITE 114 |
| City | TAMPA |
| State | FL |
| Zip Code | 33609-2288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366492878 | Mark C Klisch | Clinical Neuropsychologist | 4100 W Kennedy Blvd, Suite 327, Tampa, FL 33609-2288 | 2006-05-12 |
| 1366981946 | Foundations for Growth, Pllc | Social Worker | 4100 W Kennedy Blvd, Suite 326, Tampa, FL 33609-2288 | 2017-02-16 |
| 1922558733 | Bayada Home Health Care, Inc. | Home Health | 4100 W Kennedy Blvd, Suite 128, Tampa, FL 33609-2288 | 2016-10-05 |
| 1508311994 | Catalyst Center for Change LLC | Counselor | 4100 W Kennedy Blvd, Suite 210, Tampa, FL 33609-2288 | 2016-08-16 |
| 1699133660 | Scott Grupp | Counselor | 4100 W Kennedy Blvd, 210, Tampa, FL 33609 | 2016-02-05 |
| 1801286752 | Holistic Psychology Services, LLC | Psychologist | 4100 W Kennedy Blvd, Suite 212, Tampa, FL 33609-2288 | 2015-01-30 |
| 1174934665 | Millyan Cabrera, Lmhc, Rpt | Counselor | 4100 W Kennedy Blvd, Suite 120, Tampa, FL 33609-2288 | 2014-05-19 |
| 1407277296 | International Rehabilitative Sciences Inc. | Durable Medical Equipment & Medical Supplies | 4100 W Kennedy Blvd, Ste 208, Tampa, FL 33609-2288 | 2013-12-20 |
| 1841639929 | An Awakened Heart Psychological Approaches Tomentalhealth Wellness LLC | Community/Behavioral Health | 4100 W Kennedy Blvd, 327, Tampa, FL 33609-2288 | 2013-06-21 |
| 1053653840 | Keesha Monaie Sullivan | Social Worker | 4100 W Kennedy Blvd, Suite 327, Tampa, FL 33609-2288 | 2013-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427521970 | Kampsen Hearing LLC | Audiologist | 310 South Macdill Avenue, Suite 202, Tampa, FL 33609 | 2019-01-08 |
| 1629557319 | Priscilla Luna-mitchum | Physical Therapist | 2700 W M.l.k Jr Blvd, Suite 300, Tampa, FL 33609 | 2018-08-13 |
| 1043735657 | Mary Elizabeth Osbach | Registered Nurse | 3211 W Swann Ave, Unit 1106, Tampa, FL 33609 | 2017-08-04 |
| 1497275317 | Jeilyn M Jimenez | Developmental Therapist | 550 N Reo Street, Tampa, FL 33609 | 2017-06-21 |
| 1033658513 | Adela Reeb | Specialist/Technologist | 909 North Dale Mabry Hwy, Tampa, FL 33609 | 2017-02-17 |
| 1033561261 | Abigail Marie Richardson | Developmental Therapist | 555 North Reo Street, Tampa, FL 33609 | 2016-07-12 |
| 1275992448 | Jennifer Stich | Behavioral Analyst | 3210 W De Leon St # B, Tampa, FL 33609 | 2016-02-16 |
| 1154711505 | Health E Systems, LLC | Transportation Broker | 5100 W. Lemon Street, Suite 311, Tampa, FL 33609 | 2015-01-23 |
| 1619375292 | Healthexchange Systems, LLC | Home Health | 5100 West Lemon Street, Suite 311, Tampa, FL 33609 | 2014-12-12 |
| 1538567458 | Calvin Harrison Iv | Occupational Therapist | 600 N. Westshore Blvd, Suite 600, Tampa, FL 33609 | 2014-12-09 |
| Find all providers in zip 33609 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700393881 | Dedicated Senior Medical Center of Florida, LLC | Non-Pharmacy Dispensing Site | 1901 Fletcher Avenue, Tampa, FL 33612 | 2018-01-10 |
| 1619401338 | Dedicated Senior Medical Center East Tampa, LLC. | Non-Pharmacy Dispensing Site | 3128 East Hillsborough Avenue, Dedicated Senior Medical Center East Tampa, LLC., Tampa, FL 33610 | 2017-04-19 |
| 1891154498 | Florida Urology Partners, LLP | Non-Pharmacy Dispensing Site | 1 Davis Blvd Ste 604, Tampa, FL 33606-3480 | 2016-02-11 |
| 1275762163 | Marathon Health Care Services of Florida Pa | Non-Pharmacy Dispensing Site | 8125 Highwoods Palm Way, C/o Syniverse, Tampa, FL 33647-1776 | 2009-07-13 |
| 1922148022 | Tampa Eye Clinic Optical Center | Non-Pharmacy Dispensing Site | 3000 Dr M L King Jr Blvd, Tampa, FL 33607 | 2007-02-07 |
| 1396763934 | Continucare Medical Management, Inc. | Non-Pharmacy Dispensing Site | 200 S Macdill Ave, Suite 100, Tampa, FL 33609-3131 | 2006-07-18 |
| 1285279430 | Florida Urology Partners LLP | Non-Pharmacy Dispensing Site | 601 S Armenia Ave, Tampa, FL 33609-4123 | 2019-11-12 |
| 1619463825 | Florida Medical Clinic LLC | Non-Pharmacy Dispensing Site | 602 S Howard Ave, Tampa, FL 33606-2413 | 2018-07-11 |
| 1194239780 | Medical Home Alliance LLC | Non-Pharmacy Dispensing Site | 4700 N Habana Ave, Tampa, FL 33614-7160 | 2017-11-20 |
| 1760852776 | Tampa Pain Relief Center, Inc | Non-Pharmacy Dispensing Site | 3000 Medical Park Dr Ste 510, Tampa, FL 33613-6602 | 2015-10-02 |
| Find all providers in TAMPA | ||||
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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.