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Main Street Medical Llc
Primary Care Clinic/Center in Tampa, Florida
NPI 1487079505

Main Street Medical Llc is a Primary Care Clinic/Center based in Tampa, FL and is specialized in Primary Care. Main Street Medical Llc practices in Tampa, FL. The NPI Number for Main Street Medical Llc is 1487079505 and holds a License No. (Florida).

The current practice location address for Main Street Medical Llc is 10549 N Florida Ave Ste A/I, Tampa, FL and can be reached out via phone at 813-220-1400 and via fax at 813-440-6484. You can also correspond with Main Street Medical Llc through the mailing address at PO BOX 17175, TAMPA, FL - 33682-7175 (mailing address contact number: 813-220-1400).

Location: 10549 N Florida Ave Ste A/I, Tampa, FL, 33682-7175
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1487079505
Provider Name
Main Street Medical Llc
Credential
Provider Entity Type
Organization
Address
10549 N Florida Ave Ste A/I, Tampa, FL, 33682-7175
Phone Number
813-220-1400
Fax Number
813-440-6484
Provider Enumeration Date
02/26/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
LK078 01 FL MEDICARE
104624600 05 FL
institution
Provider Business Practice Location Address Details
Address
10549 N Florida Ave Ste A/I
City
Tampa
State
Florida
Zip
33612-6707
Phone Number
813-220-1400
Fax Number
813-440-6484
person
Provider Business Mailing Address Details
Address
Po Box 17175
City
Tampa
State
Florida
Zip
33682-7175
Phone Number
813-220-1400
Fax Number
813-341-4004
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
207QA0505X
License No.
()
Definition
Definition to come.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Addiction Medicine
Taxonomy
2084A0401X
License No.
()
Definition
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine
person
Provider's Taxonomy Details 3
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Psychiatry
Taxonomy
2084P0800X
License No.
()
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
person
Provider's Taxonomy Details 4
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 5
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
()
Definition
Definition to come...
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