Provider Demographics
NPI:1265884795
Name:BPS TAMPA, LLC
Entity type:Organization
Organization Name:BPS TAMPA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIVISION DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GROFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-746-8056
Mailing Address - Street 1:6311 ATRIUM DRIVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34202-4143
Mailing Address - Country:US
Mailing Address - Phone:941-746-8056
Mailing Address - Fax:
Practice Address - Street 1:6311 ATRIUM DRIVE
Practice Address - Street 2:SUITE 206
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34202-4143
Practice Address - Country:US
Practice Address - Phone:941-746-8056
Practice Address - Fax:941-746-2969
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BAYADA PHYSICIAN SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty