Provider Demographics
NPI:1366650160
Name:FAMILY PODIATRY GROUP OF TAMPA, P.A.
Entity Type:Organization
Organization Name:FAMILY PODIATRY GROUP OF TAMPA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:RICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:813-886-9180
Mailing Address - Street 1:7926 W HILLSBOROUGH AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4600
Mailing Address - Country:US
Mailing Address - Phone:813-886-9180
Mailing Address - Fax:813-888-9093
Practice Address - Street 1:7926 W HILLSBOROUGH AVE
Practice Address - Street 2:SUITE G
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4600
Practice Address - Country:US
Practice Address - Phone:813-886-9180
Practice Address - Fax:813-888-9093
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY PODIATRY GROP OF TAMPA, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-18
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 0001517213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106079000Medicaid
FL480002605OtherRAILROAD MEDICARE