Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Liveactive Multispecialty Physician Group Tampa LLC

Organization Internal Medicine Physician · NPI 1891556049

Liveactive Multispecialty Physician Group Tampa LLC is an Internal Medicine Physician in Brooksville, Florida. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12440 Cortez Blvd
Brooksville, FL 34613-2628
Phone: (913) 549-3884
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Hospitalist Physician (primary) Taxonomy 208M00000X
Internal Medicine Physician Taxonomy 207R00000X

Record details

NPI number1891556049
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Shane Brethowr — Ceo/Authorized Official · (913) 549-3884
Other names Liveactive Multispecialty Physician Group Tampa
NPI enumeratedJanuary 16, 2024
Last updated in NPPESSeptember 14, 2024
Certification dateSeptember 14, 2024
Mailing addressPo Box 1269, Bellevue, NE 68005-1269

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