UNIVERSITY OF SOUTH FLORIDA BOARD OF TRUSTEES
NPI 1023864147
Nurse Practitioner - Family in Tampa, FL

Q: What is University Of South Florida Board Of Trustees's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since April 29, 2024CLIA Certified · 2 labs

1309 SHORELINE AVE, TAMPA, FL 33605(813) 396-0234(866) 922-6915 Get Directions Write a Review

NPPES record last updated: April 29, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About University Of South Florida Board Of Trustees NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UNIVERSITY OF SOUTH FLORIDA BOARD OF TRUSTEES (NPI 1023864147) is a healthcare organization registered as a family in Tampa, Florida and active in the NPI registry since April 2024. The organization holds 2 active CLIA laboratory certificates and lists Duellyn Pandis, Director Of Clinical Practice, as its authorized official.

NPPES Registry Identity

NPI1023864147

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameUNIVERSITY OF SOUTH FLORIDA BOARD OF TRUSTEES

Location Address1309 SHORELINE AVETampa, FL 33605

Mailing Address12901 Bruce B Downs Blvd, Mdc 22Tampa, FL 33612 · (813) 396-0234 · Fax (866) 922-6915

Phone(813) 396-0234

Fax(866) 922-6915

Organization SubpartYesParent: The University Of South Florida Bot

Authorized OfficialDuellyn PandisDirector Of Clinical Practice · (813) 396-0234

Enumeration DateApril 29, 2024

✔ NPI 1023864147 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X

1309 SHORELINE AVE, Tampa, FL 33605

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CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 10D2009462

University Of South Florida Board Of Trustees · Tampa, FL

Active · expires Jul 5, 2028

CLIA Number10D2009462

Laboratory TypePhysician Office

Certificate Effective DateJuly 6, 2026

Certificate Expiration DateJuly 5, 2028

Laboratory DirectorDr. Eduardo C. Gonzalez

Laboratory Phone(813) 974-6017

Laboratory LocationUniversity Of South Florida Board Of Trustees13330 Usf Laurel Dr Carol And Frank Morsani Center, Tampa, FL 33612

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 10D2282110

University Of South Florida Board Of Trustees · Tampa, FL

Active · expires May 16, 2027

CLIA Number10D2282110

Laboratory TypeClinical Research Center

Certificate Effective DateMay 17, 2025

Certificate Expiration DateMay 16, 2027

Laboratory DirectorEduardo C. Gonzalez

Laboratory Phone(813) 974-3197

Laboratory LocationUniversity Of South Florida Board Of Trustees12901 Bruce B Downs Mdc28, Tampa, FL 33612

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THE UNIVERSITY OF SOUTH FLORIDA BOARD OF TRUSTEES

Nurse Practitioner (Family)

1309 SHORELINE AVE
TAMPA, FL 33605

Hillsborough County (813) 396-0234

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is University Of South Florida Board Of Trustees's NPI number?

The NPI number for University Of South Florida Board Of Trustees is 1023864147. It was assigned to this organization in the NPPES registry on April 29, 2024.

Where is University Of South Florida Board Of Trustees located?

University Of South Florida Board Of Trustees is located at 1309 Shoreline Ave, Tampa, FL 33605. The listed phone number is (813) 396-0234.

What is University Of South Florida Board Of Trustees's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does University Of South Florida Board Of Trustees hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for University Of South Florida Board Of Trustees was last updated on April 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.