Organization
TAMPA BAY EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN M BAKER MBA (EXECUTIVE DIRECTOR)
(330) 493-4443
Entity
Organization
Contact information
Practice address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
(330) 493-4443
(813) 615-7590
Mailing address
12479 TELECOM DR, TAMPA, FL 33637-0913
(330) 493-4443
(813) 972-5753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262772800
—
FL
05
—
262772801
—
FL
05
—
262772803
—
FL
05
—
262772804
—
FL
01
—
45981
BCBS OF FLORIDA
FL
Enumeration date
05/10/2006
Last updated
10/05/2016
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