Provider Demographics
NPI:1194463737
Name:TAMPA GENERAL PROVIDER NETWORK INC
Entity Type:Organization
Organization Name:TAMPA GENERAL PROVIDER NETWORK INC
Other - Org Name:TAMPA GENERAL HOSPITAL GASTRO GROUP OF THE PALM BEACHES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHWARZBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-253-3980
Mailing Address - Street 1:PO BOX 95000-7370
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-0001
Mailing Address - Country:US
Mailing Address - Phone:855-235-3496
Mailing Address - Fax:813-724-3198
Practice Address - Street 1:3401 PGA BLVD STE 500
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-2825
Practice Address - Country:US
Practice Address - Phone:561-659-6543
Practice Address - Fax:561-659-3533
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAMPA GENERAL PROVIDER NETWORK INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-24
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty