Organization Name: | PHYSICIAN PARTNERS OF AMERICA, LLC |
NPI Number: | 1972909018 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RODOLFO GARI (PRESIDENT) |
Mailing Address: | 4730 N Habana Ave Suite 204 Tampa |
State: | FL US |
Postal Code: | 336147163 |
Phone Number: | 8135492134 |
Fax Number: | 8138701383 |
NPI Enumeration Date: | 11/18/2014 |
NPI Last Update Date: | 11/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |