Provider Demographics
NPI:1851030282
Name:TAMPA GENERAL PROVIDER NETWORK INC
Entity Type:Organization
Organization Name:TAMPA GENERAL PROVIDER NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
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:
Practice Address - Street 1:12408 N 56TH ST STE 1
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-1522
Practice Address - Country:US
Practice Address - Phone:813-980-3104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAMPA GENERAL PROVIDER NETWORK INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty