Ethos Health Tampa 2, LLC
Clinic/Center, Multi-Specialty in St Petersburg, FL. Organization (NPI-2).
Details
- NPI
- 1154813640
- Entity type
- Organization (NPI-2)
- Legal business name
- Ethos Health Tampa 2, LLC
- Organization subpart
- No
- Enumeration date
- May 31, 2018
- Certification date
- Jun 29, 2021
- Last updated
- Jun 29, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
Practice location
6701 38th Ave N Ste ASt Petersburg, FL 33710-1500
Phone 352-732-5590 · Fax 352-732-0292
Mailing address
1541 Se 17th StOcala, FL 34471-4607
Phone 352-732-5590 · Fax 352-732-0292
Authorized official
Jonathan Walker
Owner/Operator
3527325590
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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