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Contact Information

SUPERIOR PHYSICIAN GROUP
10730 N 56TH ST STE 209
TEMPLE TERRACE, FL33617
 Phone: 813-365-5680
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Pain Medicine

208VP0000X 72 Physician/Pain Management
Indicates primary specialty

NPI Profile & details for SUPERIOR PHYSICIAN GROUP

NPI Number 1164912754
LBN Legal business name SUPERIOR PHYSICIAN GROUP
Authorized official RENII MODISETTE - (OPERATIONS MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/18/2018
Last updated 05/22/2018 - About 8 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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