MAIN ST MEDICAL USA NPI 1003039033

Internal Medicine (Addiction Medicine) in Tampa, FL

NPI 1003039033 Organization Internal Medicine Addiction Medicine

About MAIN ST MEDICAL USA

Main St Medical Usa is an internal medicine provider established in Tampa, Florida specializing in internal medicine (addiction medicine) . The NPI number of Main St Medical Usa is 1003039033 and was assigned on April 2007. The practitioner's primary taxonomy code is 207RA0401X. The provider is registered as an organization and their NPI record was last updated 8 years ago. Main St Medical Usa operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Stephen Allen Stefano Md (Director Md)

An internist like Main St Medical Usa is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

NPI

1003039033

Provider NameMAIN ST MEDICAL USA
Provider Location Address11734 NORTH DALE MABRY TAMPA, FL 33618
Provider Mailing Address11734 NORTH DALE MABRY TAMPA, FL 33618
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date04-10-2007
Last Update Date09-24-2013


Primary Taxonomy

Taxonomy Code207RA0401X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationAddiction Medicine
Taxonomy DescriptionAn 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.

Business Address

MAIN ST MEDICAL USA
11734 NORTH DALE MABRY
TAMPA, FL
ZIP 33618
Phone: (813) 968-6000
Fax: (813) 968-6007

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Mailing Address

MAIN ST MEDICAL USA
11734 NORTH DALE MABRY
TAMPA, FL
ZIP 33618
Phone: (813) 968-6000
Fax: (813) 968-6007



Authorized Official

Authorized Official Name STEPHEN ALLEN STEFANO MD
Authorized Official TitleDIRECTOR MD
Authorized Official Phone(813) 968-6000

Group Taxonomy


193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineNo

Taxonomy Description: a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

2208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineNo

Taxonomy Description: pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient's pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies.

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.