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DOCTORS DIET PROGRAM OF SOUTH FLORIDAPLLC NPI 1043718034


NPI Information

NPI: 1043718034
Provider Name: DOCTORS DIET PROGRAM OF SOUTH FLORIDAPLLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 10D2211730

Address:
3345 S DALE MABRY HWY
TAMPA, FL
ZIP 33629
Phone: (813) 839-3438
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DOCTORS DIET PROGRAM OF SOUTH FLORIDAPLLC is a clinic center in Tampa, FL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). DOCTORS DIET PROGRAM OF SOUTH FLORIDAPLLC NPI is 1043718034. The provider is registered as an organization entity type.

The provider's business location address is:

3345 S DALE MABRY HWY
TAMPA, FL
ZIP 33629-817
Phone: (813) 839-3438

The provider's authorized official is James Lowrance .
The authorized official title is Administrator and has the following contact phone number (813) 839-3438.

The CLIA number assigned to this NPI record is 10D2211730 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/25/2018 and was last updated on 1/25/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1L652453703740OTHERFLORIDADRIVERS LIC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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