Provider Demographics
NPI:1063641090
Name:MEDICAL CONSULTANTS OF TAMPA BAY PLLC
Entity Type:Organization
Organization Name:MEDICAL CONSULTANTS OF TAMPA BAY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DENIS
Authorized Official - Last Name:BREGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-448-3111
Mailing Address - Street 1:8870 N HIMES AVE
Mailing Address - Street 2:SUITE #360
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1627
Mailing Address - Country:US
Mailing Address - Phone:813-448-3111
Mailing Address - Fax:
Practice Address - Street 1:8870 N HIMES AVE
Practice Address - Street 2:SUITE #360
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1627
Practice Address - Country:US
Practice Address - Phone:813-448-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-12
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100150207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty