OrganizationActive
Main St Medical USA
NPI 1003039033 · Addiction Medicine (Internal Medicine) Physician · Tampa, FL
Provider details
- NPI number
- 1003039033
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Stephen Stefano, Director MD(813) 968-6000
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Pain Medicine Physician208VP0000X
Allopathic & Osteopathic Physicians
Practice location
11734 North Dale Mabry
Tampa, FL 33618
Phone: (813) 968-6000
Fax: (813) 968-6007
Approximate (ZIP-level) locationGet directions
Mailing address
11734 North Dale Mabry
Tampa, FL 33618
Registry dates
- Enumerated
- 2007-04-10
- Last updated
- 2013-09-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.