Provider Demographics
NPI:1487019519
Name:TAMPA BAY TELEHEALTH LLC
Entity Type:Organization
Organization Name:TAMPA BAY TELEHEALTH LLC
Other - Org Name:MYONCALLDOC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ZURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-441-9000
Mailing Address - Street 1:5511 PARK ST N
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33709-6309
Mailing Address - Country:US
Mailing Address - Phone:727-441-9000
Mailing Address - Fax:
Practice Address - Street 1:5511 PARK ST N
Practice Address - Street 2:SUITE 101
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33709-6309
Practice Address - Country:US
Practice Address - Phone:727-441-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 88586207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty