Provider Demographics
NPI:1013244581
Name:NEW TAMPA HOSPITALIST LLC
Entity Type:Organization
Organization Name:NEW TAMPA HOSPITALIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:THOM JUEL
Authorized Official - Middle Name:ESPINA
Authorized Official - Last Name:TIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-676-3636
Mailing Address - Street 1:10006 CROSS CREEK BLVD
Mailing Address - Street 2:# 443
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2595
Mailing Address - Country:US
Mailing Address - Phone:813-676-3636
Mailing Address - Fax:813-428-5390
Practice Address - Street 1:10006 CROSS CREEK BLVD
Practice Address - Street 2:# 443
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2595
Practice Address - Country:US
Practice Address - Phone:813-676-3636
Practice Address - Fax:813-428-5390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME101128208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherEIN