Provider Demographics
NPI:1992987200
Name:TAMPA BAY INPATIENT MEDICINE PA
Entity type:Organization
Organization Name:TAMPA BAY INPATIENT MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-681-0340
Mailing Address - Street 1:PO BOX 271489
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33688-1489
Mailing Address - Country:US
Mailing Address - Phone:813-681-0340
Mailing Address - Fax:813-961-2565
Practice Address - Street 1:4102 N MACDILL AVE STE A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6717
Practice Address - Country:US
Practice Address - Phone:813-876-4900
Practice Address - Fax:813-876-4997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0081064282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270329700Medicaid
FLH32523Medicare UPIN
FLK6394Medicare PIN