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Organization

TAMPA GENERAL MEDICAL GROUP INC

Active
Parent organization
TAMPA GENERAL MEDICAL GROUP INC
Other names
TGMG Psychology Westshore
Organization subpart
Yes

Provider details

NPI number
Legal business name
TAMPA GENERAL MEDICAL GROUP INC
Authorized official
PETER TRAVIS RIAD CHANG (VP HEALTHCARE DESIGN)
(813) 844-3829
Entity
Organization

Contact information

Practice address
1411 N WEST SHORE BLVD STE 115, TAMPA, FL 33607-4564
(813) 844-3541
(813) 844-4283
Mailing address
PO BOX 1289, TAMPA, FL 33601-1289
(813) 844-3956

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
12/08/2022
Last updated
12/19/2025
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