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Organization

ORTHOPAEDIC MEDICAL GROUP OF TAMPA BAY PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTT GOLDSMITH (MD/PRESIDENT)
(813) 534-0102
Entity
Organization

Contact information

Practice address
2805 54TH AVE N STE 100, ST PETERSBURG, FL 33714-2414
(813) 684-2663
(813) 658-6222
Mailing address
PO BOX 850001 DEPT 8272, ORLANDO, FL 32885-8272
(813) 684-2663
(813) 441-7161

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
261Q00000X
Clinic/Center
261QP2000X
Physical Therapy Clinic/Center
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
122422100
FL
Enumeration date
06/20/2017
Last updated
10/22/2024
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