Provider Demographics
NPI:1902828999
Name:NEW TAMPA MEDICAL CENTER PA
Entity Type:Organization
Organization Name:NEW TAMPA MEDICAL CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BABATOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUROJAIYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-615-2488
Mailing Address - Street 1:PO BOX 151376
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33684-1376
Mailing Address - Country:US
Mailing Address - Phone:813-615-2488
Mailing Address - Fax:813-615-2504
Practice Address - Street 1:5381 PRIMROSE LAKE CIRCLE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647
Practice Address - Country:US
Practice Address - Phone:813-615-2488
Practice Address - Fax:813-615-2504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2023-03-08
Deactivation Date:2023-01-15
Deactivation Code:
Reactivation Date:2023-03-01
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty