MAIN ST MEDICAL USA – NPI #1003039033
Internal Medicine

An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine.

MAIN ST MEDICAL USA is a provider located in TAMPA, FL. NPPES has assigned the NPI number 1003039033 to MAIN ST MEDICAL USA on April 10, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RA0401X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Addiction Medicine

The NPI profile was previously updated about 13 years ago on Sep 24, 2013. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MAIN ST MEDICAL USA below.

NPI Profile for
MAIN ST MEDICAL USA

NPI Number
1003039033
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MAIN ST MEDICAL USA
Primary location
11734 NORTH DALE MABRY
TAMPA, FL 33618
Phone: (813) 968-6000 Fax: (813) 968-6007
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
STEPHEN STEFANO
DIRECTOR MD
Phone: (813) 968-6000
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207RA0401X
- Internal Medicine / Addiction Medicine (Primary)
208VP0000X
- Pain Medicine / Pain Medicine
207R00000X
- Internal Medicine

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.