MEDICAL HOME ALLIANCE LLC (NPI# 1194239780) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194239780 |
| Entity Type | Organization |
| Organization Name | MEDICAL HOME ALLIANCE LLC |
| Other Organization Name | IMA WEST TAMPA DISPENSARY |
| Practice Address |
4700 N Habana Ave Tampa FL 33614-7160 |
| Mailing Address |
6675 Westwood Blvd Ste 475 Orlando FL 32821-6027 |
| Practice Telephone | 8134449599 |
| Practice Fax Number | 8135138210 |
| Mailing Telephone | 4078450330 |
| Mailing Fax Number | 8889721752 |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2017-11-20 |
| Authorized Official Name | PATRICIA D PEREZ (COO) |
| Authorized Official Telephone | 4078450330 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | ACN515 | FL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 018418600 | 05 |
| Other Name | Type Code |
|---|---|
| IMA West Tampa Dispensary | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740527811 | Medical Home Alliance LLC | Internal Medicine | 6675 Westwood Blvd Ste 475, Orlando, FL 32821 | 2013-01-10 |
| 1285163477 | Medical Home Alliance LLC | Non-Pharmacy Dispensing Site | 431 W Oak St, Kissimmee, FL 34741-6627 | 2017-06-09 |
| 1033648233 | Medical Home Alliance LLC | Non-Pharmacy Dispensing Site | 199 Avenue K Se, Winter Haven, FL 33880-4002 | 2017-06-09 |
| 1700315991 | Medical Home Alliance LLC | Non-Pharmacy Dispensing Site | 181 Webb Dr, Davenport, FL 33837-3964 | 2017-06-09 |
| 1609305804 | Medical Home Alliance LLC | Non-Pharmacy Dispensing Site | 7714 E Colonial Dr, Orlando, FL 32807-8422 | 2017-06-09 |
| 1235668435 | Medical Home Alliance LLC | Non-Pharmacy Dispensing Site | 1044 Plaza Dr, Kissimmee, FL 34743-4064 | 2017-06-09 |
| 1386173573 | Medical Home Alliance LLC | Non-Pharmacy Dispensing Site | 4725 Us Highway 98 S Ste 102, Lakeland, FL 33812-4334 | 2017-06-09 |
| Street Address |
4700 N HABANA AVE |
| City | TAMPA |
| State | FL |
| Zip Code | 33614-7160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952387961 | Jose M Sanchez Ojeda | General Practice | 4700 N Habana Ave, Ste 101, Tampa, FL 33614-7160 | 2005-12-21 |
| 1689135212 | Laura Renee Mercado | Dietitian, Registered | 4700 N Habana Ave, Tampa, FL 33614-7160 | 2019-03-27 |
| 1437690732 | Cecelia Addison | Counselor | 4700 N Habana Ave, Suite 500, Tampa, FL 33614-7160 | 2017-03-20 |
| 1699135061 | Tampa Vamc | Psychiatric Residential Treatment Facility | 4700 N Habana Ave, Tampa, FL 33614-7160 | 2016-02-29 |
| 1942555180 | Mcilwain Medical Group, Pa | Internal Medicine | 4700 N Habana Ave, Suite 201, Tampa, FL 33614-7160 | 2012-07-13 |
| 1952664435 | Burnette & Silverfield Mds Plc | Internal Medicine | 4700 N Habana Ave, Suite 303, Tampa, FL 33614-7160 | 2012-06-20 |
| 1881994606 | Gulfshore Pain & Wellness Centre | Clinic/Center | 4700 N Habana Ave, 403, Tampa, FL 33614-7160 | 2010-10-26 |
| 1023248945 | Jessica Mesa | Massage Therapist | 4700 N Habana Ave, 700, Tampa, FL 33614-7160 | 2009-07-27 |
| 1982839510 | Relief Medical Center, LLC | Legal Medicine | 4700 N Habana Ave, Suite 701, Tampa, FL 33614-7160 | 2009-05-27 |
| 1821256629 | Seifu M Demissie | Pediatrics | 4700 N Habana Ave, Suite 200, Tampa, FL 33614-7160 | 2008-05-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134733082 | Robin Rollena Stewart | Home Health | 9537 Lazy Lane, Apt 302, Tampa, FL 33614 | 2020-09-08 |
| 1346885761 | David Joseph Page | Nurse Practitioner | St. Joseph's Behavioral Health Center, 4918 N. Habana Ave, Tampa, FL 33614 | 2019-11-08 |
| 1134687411 | Ramon Chang Adult Family Care Home LLC | Custodial Care Facility | 2607 W Humphrey St, Tampa, FL 33614 | 2019-03-06 |
| 1134600612 | Senior Point Assisted Living Facility, LLC | Assisted Living Facility | 2940 W Hillsborough Ave, Tampa, FL 33614 | 2018-08-23 |
| 1306361266 | Larry Valdes | Assisted Living Facility | 4402 W Minnehaha St, Tampa, FL 33614 | 2017-08-11 |
| 1982128062 | Jaime F Casellas Md Corp | Internal Medicine | 4600 N Habana Ave Suit #13, Tampa, FL 33614 | 2017-07-31 |
| 1891219119 | Waveney Gittens-williams | Alzheimer Center (Dementia Center) | 3706 W. Idle Wild Cir #203, Tampa, FL 33614 | 2017-07-28 |
| 1750811857 | Syerita Nicole Morris | Counselor | 6800 N Dale Marby Hwy, Ste 164, Tampa, FL 33614 | 2017-06-13 |
| 1447786124 | Lisa Moy | Case Manager/Care Coordinator | 4001 W. Dr. Martin Luther King Jr. Blvd., Tampa, FL 33614 | 2017-05-02 |
| 1750813804 | Joshua Martin Good | Physical Therapy Assistant | 3363 W. Waters Avenue, Suite 700, Tampa, FL 33614 | 2017-03-29 |
| Find all providers in zip 33614 | ||||
| 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 |
| 1760852776 | Tampa Pain Relief Center, Inc | Non-Pharmacy Dispensing Site | 3000 Medical Park Dr Ste 510, Tampa, FL 33613-6602 | 2015-10-02 |
| 1205206216 | Tampa Pain Relief Center, Inc | Non-Pharmacy Dispensing Site | 2333 W Hillsborough Ave, Ste 100, Tampa, FL 33603-1052 | 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.