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PASSPORT HEALTH OF TAMPA BAY
NPI 1699968909
Clinic/Center - Health Service in Tampa, FL

Active since August 20, 2007CLIA 10D1089699 · Waiver
4202 W LINEBAUGH AVE, TAMPA, FL 33624(813) 969-3757 Get Directions Write a Review

NPPES record last updated: June 3, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 3, 2026, Sep 1, 2020 (2 updates tracked since 2020).

About Passport Health Of Tampa Bay NPPES

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

PASSPORT HEALTH OF TAMPA BAY (NPI 1699968909) is a healthcare organization registered as a health service in Tampa, Florida and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through September 23, 2026 and lists Duellyn Z Pandis, Clinic Director, as its authorized official.

NPPES Registry Identity

NPI1699968909
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NamePASSPORT HEALTH OF TAMPA BAY
Location Address4202 W LINEBAUGH AVETampa, FL 33624-5241
Mailing Address4202 W Linebaugh AveTampa, FL 33624-5241 · (813) 969-3757
Phone(813) 969-3757
Organization SubpartNo
Authorized OfficialDuellyn Z PandisClinic Director · (813) 969-3757
Enumeration DateAugust 20, 2007
Last NPPES UpdateJune 3, 20262 updates tracked since enumeration
NPPES CertifiedJune 3, 2026
✔ NPI 1699968909 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
License✔ Licensed in FL · RN2855132
4202 W LINEBAUGH AVE, Tampa, FL 33624
Open in Google Maps ↗

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 10D1089699

Passport Health Of Tampa Bay · Tampa, FL
Active · expires Sep 23, 2026
CLIA Number10D1089699
Laboratory TypeHealth Fair
Certificate Effective DateSeptember 24, 2024
Certificate Expiration DateSeptember 23, 2026
Laboratory DirectorDuellyn Z. Pandis
Laboratory Phone(813) 969-3757
Laboratory LocationPassport Health Of Tampa Bay4204 W Linebaugh Ave, Tampa, FL 33624
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

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

FLORIDA APNEA DIAGNOSTICS LLC
Clinic/Center (Sleep Disorder Diagnostic)
4202 W LINEBAUGH AVE
TAMPA, FL 33624
Hillsborough County (813) 279-5012
PASSPORT HEALTH OF TAMPA BAY
Clinic/Center (Health Service)
4202 W LINEBAUGH AVE
TAMPA, FL 33624
Hillsborough County (813) 969-3757
PASSPORT HEALTH HOLDINGS, LLC
Community Health Worker
4202 W LINEBAUGH AVE
TAMPA, FL 33624
Hillsborough County (877) 358-8648

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 Passport Health Of Tampa Bay's NPI number?

The NPI number for Passport Health Of Tampa Bay is 1699968909. It was assigned to this organization in the NPPES registry on August 20, 2007.

Where is Passport Health Of Tampa Bay located?

Passport Health Of Tampa Bay is located at 4202 W Linebaugh Ave, Tampa, FL 33624. The listed phone number is (813) 969-3757.

What is Passport Health Of Tampa Bay's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

Does Passport Health Of Tampa Bay hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1089699) is associated with this NPI, valid through September 23, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Passport Health Of Tampa Bay was last updated on June 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.