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WEST TAMPA MEDICAL GROUP,LLC
NPI 1144522988
Clinic/Center in Tampa, FL

Active since November 30, 2010CLIA 10D2104991 · Waiver
2601 N HIMES AVE, TAMPA, FL 33607(813) 873-8071(813) 877-4031 Get Directions Write a Review

NPPES record last updated: April 10, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 10, 2026, Dec 17, 2024, Sep 20, 2024 (3 updates tracked since 2024).

About West Tampa Medical Group,llc NPPES

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

WEST TAMPA MEDICAL GROUP,LLC (NPI 1144522988), doing business as Revello Medical Center, is a healthcare organization registered as a clinic/center in Tampa, Florida and active in the NPI registry since November 2010. The organization holds a CLIA Waiver certificate valid through November 16, 2027 and lists Antonio Calvo, Coo, as its authorized official.

NPPES Registry Identity

NPI1144522988
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameWEST TAMPA MEDICAL GROUP,LLC
Location Address2601 N HIMES AVETampa, FL 33607-2112
Mailing Address5901 Webb RdTampa, FL 33615-3219 · (813) 888-8215 · Fax (813) 885-5398
Phone(813) 873-8071
Fax(813) 877-4031
Organization SubpartNo
Authorized OfficialAntonio CalvoCoo · (813) 888-8215
Enumeration DateNovember 30, 2010
Last NPPES UpdateApril 10, 20263 updates tracked since enumeration
NPPES CertifiedApril 10, 2026
✔ NPI 1144522988 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Also ListedFamily MedicineTaxonomy 207Q00000X
2601 N HIMES AVE, Tampa, FL 33607
Open in Google Maps ↗

Other Names 1

Doing Business AsRevello Medical Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

West Tampa Medical Group,llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to West Tampa Medical Group,llc, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Jose Garcia, M.D.
Family Practice
NPI 1023010832
2601 N HIMES AVE
Tampa, FL 33607
(813) 873-8071
✔ PECOSSame address
Zoilamis Gutierrez Candelario, NP-C
Nurse Practitioner
NPI 1821680893
2601 N HIMES AVE
Tampa, FL 33607
(813) 873-8071
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

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 of Waiver 10D2104991

West Tampa Medical Group LLC · Tampa, FL
Active · expires Nov 16, 2027
CLIA Number10D2104991
Laboratory TypePhysician Office
Certificate Effective DateNovember 17, 2025
Certificate Expiration DateNovember 16, 2027
Laboratory DirectorPatricia Revello
Laboratory Phone(813) 873-8071
Laboratory LocationWest Tampa Medical Group LLC2601 N Himes Ave, Tampa, FL 33607
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 West Tampa Medical Group,llc's NPI number?

The NPI number for West Tampa Medical Group,llc is 1144522988. It was assigned to this organization in the NPPES registry on November 30, 2010. The provider is doing business as Revello Medical Center.

Where is West Tampa Medical Group,llc located?

West Tampa Medical Group,llc is located at 2601 N Himes Ave, Tampa, FL 33607. The listed phone number is (813) 873-8071.

What is West Tampa Medical Group,llc's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is West Tampa Medical Group,llc enrolled in Medicare?

Yes. West Tampa Medical Group,llc is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through West Tampa Medical Group,llc?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to West Tampa Medical Group,llc, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does West Tampa Medical Group,llc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2104991) is associated with this NPI, valid through November 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for West Tampa Medical Group,llc was last updated on April 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.