# ROOT CAUSE MEDICAL CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Axe Holistic Medicine, Root Cause Medical Clinic Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962854802
- **Authorized official:** JORDAN MATTHEW AXE (OWNER/PRESIDENT)
- **Authorized official phone:** (937) 216-9048

## Contact information

- **Practice address:** 15049 BRUCE B DOWNS BLVD, TAMPA, FL 33647-1388
- **Practice address phone:** (937) 216-9048
- **Practice address fax:** (844) 828-3997
- **Mailing address:** 15049 BRUCE B DOWNS BLVD, TAMPA, FL 33647-1388
- **Mailing address phone:** (937) 216-9048
- **Mailing address fax:** (844) 828-3997

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | — | — |
| 207L00000X | Anesthesiology Physician | — | — | — |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | — | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LG0600X | Gerontology Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/04/2016
- **Last updated:** 08/06/2025