Provider Demographics
NPI:1124287065
Name:EXCEPTIONAL CARE OF TAMPA, INC.
Entity type:Organization
Organization Name:EXCEPTIONAL CARE OF TAMPA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/MANAGING PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:C
Authorized Official - Last Name:KARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-963-0618
Mailing Address - Street 1:14502 N DALE MABRY HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2075
Mailing Address - Country:US
Mailing Address - Phone:813-963-0618
Mailing Address - Fax:877-996-6394
Practice Address - Street 1:14502 N DALE MABRY HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2075
Practice Address - Country:US
Practice Address - Phone:813-963-0618
Practice Address - Fax:877-996-6394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL6887317-98251S00000X
FL6887317-96251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6887317-98Medicaid
FL6887317-96Medicaid