ETHOS HEALTH TAMPA 1, LLC (NPI# 1285126763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285126763 |
| Entity Type | Organization |
| Organization Name | ETHOS HEALTH TAMPA 1, LLC |
| Practice Address |
4600 N Habana Ave Ste 25 Tampa FL 33614-7123 |
| Mailing Address |
1541 Se 17th St Ocala FL 34471-4607 |
| Practice Telephone | 3527325590 |
| Practice Fax Number | 3527320292 |
| Mailing Telephone | 3527325590 |
| Mailing Fax Number | 3527320292 |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-05-31 |
| Authorized Official Name | JONATHAN WALKER (OWNER/OPERATOR) |
| Authorized Official Telephone | 3527325590 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
4600 N HABANA AVE STE 25 |
| City | TAMPA |
| State | FL |
| Zip Code | 33614-7123 |
| 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 | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| 1023664059 | Guidewell Sanitas I, LLC | Clinic/Center | 12845 Citrus Plaza Dr, Tampa, FL 33625-3010 | 2019-08-15 |
| 1477119519 | Shilo LLC | Clinic/Center | 10549 N Florida Ave Ste J, Tampa, FL 33612-6707 | 2019-05-14 |
| 1700387479 | Forcare Medical Group, Inc. | Clinic/Center | 15402 N Florida Ave, Tampa, FL 33613-1244 | 2018-02-27 |
| 1609212299 | Blue Horseshoe Wellness, Inc | Clinic/Center | 334 South Hyde Park Ave, Tampa, FL 33606 | 2013-05-22 |
| 1457521601 | West Coast Chiropractic & Medical Center, Inc. | Clinic/Center | 8502 N Armenia Ave, Suite 2b, Tampa, FL 33604-2567 | 2008-03-04 |
| 1326221151 | Mobilelab,co | Clinic/Center | 2301 E Sligh Ave, Suite 39, Tampa, FL 33610-1336 | 2007-12-15 |
| 1174736995 | Hyde Park Counseling Center | Clinic/Center | 207 W Verne St, Tampa, FL 33606-2332 | 2007-05-08 |
| 1427197250 | Doctors R Us Walk-in Clinic, Inc. | Clinic/Center | 6821 W Hillsborough Ave, #19, Tampa, FL 33634-5003 | 2007-02-06 |
| 1902810963 | Physical Medicine Center | Clinic/Center | 14522 University Point Pl, Tampa, FL 33613-5425 | 2006-07-27 |
| 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.