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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
TGMG Sunlake
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 FHSC)
(813) 844-3956
Entity
Organization
Contact information
Practice address
19027 WINGSHOOTER WAY, LUTZ, FL 33558
(813) 660-7900
(813) 821-9821
Mailing address
PO BOX 1289, TAMPA, FL 33601-1289
(813) 844-3956
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/10/2024
Last updated
12/19/2025
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