Provider Demographics
NPI:1063151405
Name:TAMPA GENERAL PROVIDER NETWORK INC
Entity type:Organization
Organization Name:TAMPA GENERAL PROVIDER NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABRAHAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:SCHWARZBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-253-3980
Mailing Address - Street 1:PO BOX 95000-7370
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-0001
Mailing Address - Country:US
Mailing Address - Phone:855-235-3496
Mailing Address - Fax:
Practice Address - Street 1:4949 4TH ST N
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-3800
Practice Address - Country:US
Practice Address - Phone:813-660-6950
Practice Address - Fax:813-660-6622
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TAMPA GENERAL PROVIDER NETWORK INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-02
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty