# ORTHOPAEDIC MEDICAL GROUP OF TAMPA BAY PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740407121
- **Authorized official:** DR. SCOTT E GOLDSMITH MD (PRESIDENT)
- **Authorized official phone:** (813) 684-2663

## Contact information

- **Practice address:** 13837 CIRCA CROSSING DR, LITHIA, FL 33547
- **Practice address phone:** (813) 684-2663
- **Practice address fax:** (813) 441-7161
- **Mailing address:** PO BOX 850001 DEPT 8272, ORLANDO, FL 32885-8272
- **Mailing address phone:** (813) 684-2663
- **Mailing address fax:** (813) 441-7161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207T00000X | Neurological Surgery Physician | — | NULL | — |
| 207T00000X | Neurological Surgery Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 04/19/2007
- **Last updated:** 10/22/2024