Provider Demographics
NPI: | 1043557853 |
---|---|
Name: | TAMPA GENERAL MEDICAL GROUP INC |
Entity Type: | Organization |
Organization Name: | TAMPA GENERAL MEDICAL GROUP INC |
Other - Org Name: | TGMG BAYSHORE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | CHIEF MEDICAL INFORMATICS OFFICER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | PETER |
Authorized Official - Middle Name: | T |
Authorized Official - Last Name: | CHANG |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 813-844-3956 |
Mailing Address - Street 1: | PO BOX 1289 |
Mailing Address - Street 2: | |
Mailing Address - City: | TAMPA |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33601-1289 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 813-844-3956 |
Mailing Address - Fax: | 813-844-4712 |
Practice Address - Street 1: | 409 BAYSHORE BLVD |
Practice Address - Street 2: | |
Practice Address - City: | TAMPA |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33606-2707 |
Practice Address - Country: | US |
Practice Address - Phone: | 813-844-5544 |
Practice Address - Fax: | 813-844-1655 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-01-14 |
Last Update Date: | 2024-02-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
No | 207QG0300X | Allopathic & Osteopathic Physicians | Family Medicine | Geriatric Medicine | Group - Multi-Specialty |
No | 207RB0002X | Allopathic & Osteopathic Physicians | Internal Medicine | Obesity Medicine | Group - Multi-Specialty |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | Group - Multi-Specialty |
No | 207RI0008X | Allopathic & Osteopathic Physicians | Internal Medicine | Hepatology | Group - Multi-Specialty |
No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
No | 207RX0202X | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology | Group - Multi-Specialty |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty | |
No | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Group - Multi-Specialty |