PHYSICAL MEDICINE CENTER NPI 1902810963

NPI Information

NPI: 1902810963
Provider Name: PHYSICAL MEDICINE CENTER
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 10D1032176

Address:
14522 UNIVERSITY POINT PL
TAMPA, FL
ZIP 33613
Phone: (813) 978-0020
Get Directions

PHYSICAL MEDICINE CENTER is a multi-specialty clinic center in Tampa, FL. PHYSICAL MEDICINE CENTER NPI is 1902810963. The provider is registered as an organization entity type.

The provider's business location address is:

14522 UNIVERSITY POINT PL
TAMPA, FL
ZIP 33613-425
Phone: (813) 978-0020
Fax: (813) 972-9024

The provider's authorized official is Robert Carl Lupo .
The authorized official title is Owner/clinic Director and has the following contact phone number (813) 978-0020.

The CLIA number assigned to this NPI record is 10D1032176 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/27/2006 and was last updated on 8/16/2010.

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	261QM1300X	Clinic/Center	Multi-Specialty			Yes

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
1	21592	OTHER	FLORIDA	BCBS
2	22031	OTHER	FLORIDA	BCBS
3	CH8350	OTHER	FLORIDA	LICENSE
4	PT9405	OTHER	FLORIDA	LICENSE#
5	CH9181	OTHER	FLORIDA	LICENSE NUMBER
6	12043	OTHER	FLORIDA	BCBS
7	D61599	MEDICARE UPIN	FLORIDA
8	V4199A	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA
9	CH8937	OTHER	FLORIDA	LICENSE#
10	V03750	MEDICARE UPIN	FLORIDA
11	T84275	MEDICARE UPIN	FLORIDA
12	12043A	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA
13	22031	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA
14	U67258	MEDICARE UPIN	FLORIDA
15	CH5346	OTHER	FLORIDA	LICENSE#
16	ME23061	OTHER	FLORIDA	LICENSE#

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

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