Provider Demographics
NPI:1841595436
Name:THE CENTER FOR INTERNAL MEDICINE, INC
Entity Type:Organization
Organization Name:THE CENTER FOR INTERNAL MEDICINE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VARGHESE
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-238-3300
Mailing Address - Street 1:701 W MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-3100
Mailing Address - Country:US
Mailing Address - Phone:813-238-3300
Mailing Address - Fax:813-238-3310
Practice Address - Street 1:701 W MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-3100
Practice Address - Country:US
Practice Address - Phone:813-238-3300
Practice Address - Fax:813-238-3310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-13
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67514207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty