Organization
TAMPA BAY SERVICES GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISMARY PADRON (CEO)
(813) 382-1172
Entity
Organization
Contact information
Practice address
8313 W HILLSBOROUGH AVE STE 110, TAMPA, FL 33615-3819
(813) 382-1172
(813) 801-3044
Mailing address
8313 W HILLSBOROUGH AVE STE 110, TAMPA, FL 33615-3819
(813) 382-1172
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225700000X
Massage Therapist
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109675200
—
FL
Enumeration date
02/10/2021
Last updated
03/15/2022
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