SHILO LLC (NPI# 1477119519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
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 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Colorado Business Entities | Shilo LLC | 165 County Road 231, Durango, CO 81303 |
Street Address |
10549 N FLORIDA AVE STE J |
City | TAMPA |
State | FL |
Zip Code | 33612-6707 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689286767 | Daniel Jimenez | Physical Therapist | 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 | 2020-08-19 |
1700426830 | Taz Stacy | Behavior Technician | 2701 University Square Drive, Tampa, FL 33612 | 2020-01-07 |
1841853215 | Eric Austen Keeler | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-20 |
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 |
1295202489 | Daisy Baby Pulinilkumkalayil | Nurse Practitioner | 1426 W. Bush Blvd. Suite #105, Suite #105, Tampa, FL 33612 | 2018-10-26 |
1649745258 | Rachel Rene Shelton | Specialist/Technologist | Orthopedics and Sports Medicine, 13330 Usf Laurel Drive, Tampa, FL 33612 | 2018-10-10 |
Find all providers in zip 33612 |
Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
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1285126763 | Ethos Health Tampa 1, LLC | Clinic/Center | 4600 N Habana Ave Ste 25, Tampa, FL 33614-7123 | 2018-05-31 |
1700387479 | Forcare Medical Group, Inc. | Clinic/Center | 15402 N Florida Ave, Tampa, FL 33613-1244 | 2018-02-27 |
1609212299 | Blue Horseshoe Wellness, Inc | Clinic/Center | 334 South Hyde Park Ave, Tampa, FL 33606 | 2013-05-22 |
1457521601 | West Coast Chiropractic & Medical Center, Inc. | Clinic/Center | 8502 N Armenia Ave, Suite 2b, Tampa, FL 33604-2567 | 2008-03-04 |
1326221151 | Mobilelab,co | Clinic/Center | 2301 E Sligh Ave, Suite 39, Tampa, FL 33610-1336 | 2007-12-15 |
1174736995 | Hyde Park Counseling Center | Clinic/Center | 207 W Verne St, Tampa, FL 33606-2332 | 2007-05-08 |
1427197250 | Doctors R Us Walk-in Clinic, Inc. | Clinic/Center | 6821 W Hillsborough Ave, #19, Tampa, FL 33634-5003 | 2007-02-06 |
1902810963 | Physical Medicine Center | Clinic/Center | 14522 University Point Pl, Tampa, FL 33613-5425 | 2006-07-27 |
Find all providers in TAMPA |
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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.