Mdside

Internal Medicine · Tampa, FL

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At a glance

109 N 12Th St Ste 1105, Tampa, FL 33602-3686

NPPES record updated Feb 24, 2025. Public records can lag behind changes at a practice.

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Practice location

109 N 12Th St Ste 1105
Tampa, FL 33602-3686

Professional details: NPI, taxonomy & registry record

NPI1861298218

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Registry details

Primary taxonomy: Internal Medicine
Taxonomy code: 207R00000X
Enumeration date: Feb 24, 2025
Record updated: Feb 24, 2025

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Internal Medicine

207R00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

109 N 12Th St Ste 1105
Tampa, FL 33602-3686

Phone: (813) 808-3142
Fax: (813) 591-4522

Mailing address

401 E JACKSON ST STE 2340-K14

TAMPA, FL 336025233

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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