SHILO LLC


Address: 10549 N Florida Ave Ste J, Tampa, FL 33612-6707
Phone: 8132520242

SHILO LLC (NPI# 1477119519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477119519
Entity Type Organization
Organization Name SHILO LLC
Other Organization Name SHILOH MEDICAL GROUP
Practice Address 10549 N Florida Ave Ste J
Tampa
FL 33612-6707
Mailing Address Po Box 17175
Tampa
FL 33682-7175
Practice Telephone 8132520242
Enumeration Date 2019-05-14
Last Update Date 2020-07-21
Authorized Official Name STEPHEN O BANJOKO (CFO)
Authorized Official Telephone 2122570225
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
SHILOH MEDICAL GROUP Doing Business As Name - Organization
TAMPA PAIN CLINIC Doing Business As Name - Organization
TAMPA SUBOXONE CLINIC Doing Business As Name - Organization

Other Data Sources

Entity Type Entity Name Entity Address
Colorado Business Entities Shilo LLC 165 County Road 231, Durango, CO 81303

Office Location

Street Address 10549 N FLORIDA AVE STE J
City TAMPA
State FL
Zip Code 33612-6707

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NPI Name Taxonomy Address Enumeration
1689286767 Daniel Jimenez Physical Therapist 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 2020-08-19
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1346700242 Caitlyn Victoria Cartwright Student in an Organized Health Care Education/Training Program 12901 Bruce B. Downs Blvd., Mdc5, Tampa, FL 33612 2019-03-25
1720552953 Marijo Bilitski Student in an Organized Health Care Education/Training Program 12901 Bruce B Downs Blvd # Blvd5, Tampa, FL 33612 2019-01-22
1790259190 Belkis Aleman Nurse Practitioner 205 E Busch Blvd, Tampa, FL 33612 2019-01-18
1811469133 Stephanie Stegner Physician Assistant 12901 Bruce B Downs Blvd Mdc 5, Tampa, FL 33612 2018-12-27
1053889857 Alysia Heather Siegel Psychologist 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 2018-11-09
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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

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1609212299 Blue Horseshoe Wellness, Inc Clinic/Center 334 South Hyde Park Ave, Tampa, FL 33606 2013-05-22
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Competitor

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City TAMPA
Zip Code 33612

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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