| Internal Medicine Of Tampa Bay | |
|
2835 W De Leon St Ste 102 Tampa FL 33609-4130 | |
| (813) 336-5808 | |
| (813) 822-0040 |
| Full Name | Internal Medicine Of Tampa Bay |
|---|---|
| Speciality | Internal Medicine |
| Location | 2835 W De Leon St Ste 102, Tampa, Florida |
| Authorized Official Name and Position | Manish Sobti (ADMINISTRATOR) |
| Authorized Official Contact | 7272695618 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Of Tampa Bay Po Box 49106 Saint Petersburg FL 33743-9106 Ph: (727) 269-5618 | Internal Medicine Of Tampa Bay 2835 W De Leon St Ste 102 Tampa FL 33609-4130 Ph: (813) 336-5808 |
| NPI Number | 1033759527 |
|---|---|
| Provider Enumeration Date | 01/13/2020 |
| Last Update Date | 09/21/2023 |
| Medicare PECOS PAC ID | 9739505751 |
|---|---|
| Medicare Enrollment ID | O20200820001471 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033759527 | NPI | - | NPPES |
| 004191800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Preeti Kallu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164615829 PECOS PAC ID: 6709922784 Enrollment ID: I20120104000841 |
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