Provider Demographics
NPI:1467099051
Name:TAMPA BAY NEUROLOGY AND SLEEP MEDICINE, LLC
Entity Type:Organization
Organization Name:TAMPA BAY NEUROLOGY AND SLEEP MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARUN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-993-9760
Mailing Address - Street 1:110 S MACDILL AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3129
Mailing Address - Country:US
Mailing Address - Phone:813-564-0140
Mailing Address - Fax:813-296-2010
Practice Address - Street 1:110 S MACDILL AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3129
Practice Address - Country:US
Practice Address - Phone:813-564-0140
Practice Address - Fax:813-296-2010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-03
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder DiagnosticGroup - Multi-Specialty