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FLORIDA PRIMARY CARE CLINICS
Complete NPI Record 1386026342
Nurse Practitioner - Family in Tampa, FL

NPI Status: Active since June 25, 2015

Contact Information

4726 N HABANA AVE
SUITE 203
TAMPA, FL
ZIP 33614
Phone: (813) 549-2134
Fax: (813) 870-1383

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider Other Organization Name
  6. Provider Other Organization Name Type Code
  7. Provider First Line Business Mailing Address
  8. Provider Second Line Business Mailing Address
  9. Provider Business Mailing Address City Name
  10. Provider Business Mailing Address State Name
  11. Provider Business Mailing Address Postal Code
  12. Provider Business Mailing Address Country Code If outside U S
  13. Provider Business Mailing Address Telephone Number
  14. Provider Business Mailing Address Fax Number
  15. Provider First Line Business Practice Location Address
  16. Provider Second Line Business Practice Location Address
  17. Provider Business Practice Location Address City Name
  18. Provider Business Practice Location Address State Name
  19. Provider Business Practice Location Address Postal Code
  20. Provider Business Practice Location Address Country Code If outside U S
  21. Provider Business Practice Location Address Telephone Number
  22. Provider Business Practice Location Address Fax Number
  23. Provider Enumeration Date
  24. Last Update Date
  25. Authorized Official Last Name
  26. Authorized Official First Name
  27. Authorized Official Title or Position
  28. Authorized Official Telephone Number
  29. Healthcare Provider Taxonomy Code 1
  30. Healthcare Provider Primary Taxonomy Switch 1
  31. Healthcare Provider Taxonomy Code 2
  32. Healthcare Provider Primary Taxonomy Switch 2
  33. Is Organization Subpart
  34. Parent Organization LBN
  35. Parent Organization TIN
  36. Healthcare Provider Taxonomy Group 1
  37. Healthcare Provider Taxonomy Group 2

Complete NPI Dataset

This page represents the complete record for NPI 1386026342. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1386026342
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization Name: FLORIDA PRIMARY CARE CLINICS
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Other Organization Name Type Code: 3
The city name in the mailing address of the provider being identified.
Provider First Line Business Mailing Address: 4730 N HABANA AVE
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Second Line Business Mailing Address: SUITE 204
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address City Name: TAMPA
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address State Name: FL
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Postal Code: 336147163
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Mailing Address Country Code If outside U S : US
The city name in the location address of the provider being identified.
Provider Business Mailing Address Telephone Number: 8135492134
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 8138701383
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 4726 N HABANA AVE
The country code in the location address of the provider being identified.
Provider Second Line Business Practice Location Address: SUITE 203
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: TAMPA
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: FL
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 336147144
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 8135492134
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 8138701383
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/25/2015
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 6/25/2015
The date that a record was last updated or changed.
Authorized Official Last Name: WOOD
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: DAVID
The first name of the authorized official.
Authorized Official Title or Position: MANAGER
The title or position of the authorized official.
Authorized Official Telephone Number: 8135492134
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 207Q00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 363LF0000X
Healthcare Provider Primary Taxonomy Switch 2: Y
Is Organization Subpart: Y
Parent Organization LBN: PHYSICIAN PARTNERS OF AMERICA FLORIDA MEDICAL HOLDINGS LLC
Parent Organization TIN: UNAVAIL
Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP
Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP