Provider Demographics
NPI:1134895212
Name:FLORIDA HOSPITAL PHYSICIAN GROUP INC
Entity type:Organization
Organization Name:FLORIDA HOSPITAL PHYSICIAN GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:PRESSWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-615-4237
Mailing Address - Street 1:3617 W HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-4055
Mailing Address - Country:US
Mailing Address - Phone:813-467-4265
Mailing Address - Fax:813-467-4267
Practice Address - Street 1:3617 W HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-4055
Practice Address - Country:US
Practice Address - Phone:813-467-4265
Practice Address - Fax:813-467-4267
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FLORIDA HOSPITAL PHYSICIAN GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-19
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic SurgeryGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty