PASSPORT HEALTH OF TAMPA BAY NPI 1699968909

NPI Information

NPI: 1699968909
Provider Name: PASSPORT HEALTH OF TAMPA BAY
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 10D1089699

Address:
4204 W LINEBAUGH AVE
TAMPA, FL
ZIP 33624
Phone: (813) 969-3757
Get Directions

PASSPORT HEALTH OF TAMPA BAY is a health service clinic center in Tampa, FL. PASSPORT HEALTH OF TAMPA BAY NPI is 1699968909. The provider is registered as an organization entity type.

The provider's business location address is:

4204 W LINEBAUGH AVE
TAMPA, FL
ZIP 33624-241
Phone: (813) 969-3757

The provider's authorized official is Duellyn Z Pandis .
The authorized official title is Executive Director and has the following contact phone number (813) 969-3757.

The CLIA number assigned to this NPI record is 10D1089699 - health fair with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/20/2007 and was last updated on 9/1/2020.

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
1	261QH0100X	Clinic/Center	Health Service	RN2855132	FLORIDA	Yes

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

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »