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Organization
TAMPA GENERAL MEDICAL GROUP INC
Active
Organization
TAMPA GENERAL MEDICAL GROUP INC
Active
Parent organization
TAMPA GENERAL MEDICAL GROUP INC
Other names
TGH Crystal River Wound Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
TAMPA GENERAL MEDICAL GROUP INC
Authorized official
PETER TRAVIS RIAD CHANG (SVP CHIEF TRNSFRMTN OFCR)
(813) 844-3829
Entity
Organization
Contact information
Practice address
1601 SE US HIGHWAY 19 STE 1667, CRYSTAL RIVER, FL 34429-4830
(352) 563-2407
Mailing address
PO BOX 1289, TAMPA, FL 33601-1289
(813) 844-3956
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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