Provider Demographics
NPI: | 1225451180 |
---|---|
Name: | TEAM PHYSICIANS, LLC |
Entity type: | Organization |
Organization Name: | TEAM PHYSICIANS, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRINCIPLE |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | ARNOLD |
Authorized Official - Middle Name: | M |
Authorized Official - Last Name: | RAMIREZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 727-593-4260 |
Mailing Address - Street 1: | 4200 54TH AVE S |
Mailing Address - Street 2: | |
Mailing Address - City: | ST PETERSBURG |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33711-4744 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 727-864-7831 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4200 54TH AVE S |
Practice Address - Street 2: | |
Practice Address - City: | ST PETERSBURG |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33711-4744 |
Practice Address - Country: | US |
Practice Address - Phone: | 727-864-7831 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-01-29 |
Last Update Date: | 2014-01-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | ME71434 | 207QS0010X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207QS0010X | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | Group - Single Specialty |