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MYRTLE RIDGE FAMILY MEDICINE, PA
NPI 1427195809
Family Medicine in Lutz, FL

Active since February 01, 2007
1539 DALE MABRY HWY, 102, LUTZ, FL 33548(813) 909-7102(813) 909-0199 Get Directions Write a Review

NPPES record last updated: January 10, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Myrtle Ridge Family Medicine, Pa NPPES

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

MYRTLE RIDGE FAMILY MEDICINE, PA (NPI 1427195809) is a healthcare organization registered as a family medicine in Lutz, Florida and active in the NPI registry since February 2007. The organization lists Jack Bergh, Ceo, as its authorized official.

NPPES Registry Identity

NPI1427195809
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMYRTLE RIDGE FAMILY MEDICINE, PA
Location Address1539 DALE MABRY HWY, 102Lutz, FL 33548-3008
Mailing AddressPo Box 660Lutz, FL 33548-0660 · (813) 909-7102 · Fax (813) 909-0199
Phone(813) 909-7102
Fax(813) 909-0199
Organization SubpartNo
Authorized OfficialJack BerghCeo · (813) 909-7102
Enumeration DateFebruary 1, 2007
Last NPPES UpdateJanuary 10, 2013
✔ NPI 1427195809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · ME0056971
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1539 DALE MABRY HWY, Lutz, FL 33548
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Other Identifiers 3

Medicare PINK8377FL
Medicaid770008300FL
Medicare UPINE91794

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

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 Myrtle Ridge Family Medicine, PA's NPI number?

The NPI number for Myrtle Ridge Family Medicine, PA is 1427195809. It was assigned to this organization in the NPPES registry on February 1, 2007.

Where is Myrtle Ridge Family Medicine, PA located?

Myrtle Ridge Family Medicine, PA is located at 1539 Dale Mabry Hwy 102, Lutz, FL 33548. The listed phone number is (813) 909-7102.

What is Myrtle Ridge Family Medicine, PA's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

What insurance does Myrtle Ridge Family Medicine, PA accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Myrtle Ridge Family Medicine, PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Myrtle Ridge Family Medicine, PA was last updated on January 10, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.