| |
1104 W Kennedy Blvd, Tampa, FL 33606-1966 | |
(813) 258-6051 | |
(813) 258-6064 |
Full Name | |
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Type | Facility |
Speciality | Physical Medicine & Rehabilitation |
Location | 1104 W Kennedy Blvd, Tampa, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437366044 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | CH8475 (Florida) | Primary |
208100000X | Physical Medicine & Rehabilitation | OS7727 (Florida) | Primary |
Mailing Address | Practice Location Address |
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1104 W Kennedy Blvd, Tampa, FL 33606-1966 Ph: (813) 258-6051 | 1104 W Kennedy Blvd, Tampa, FL 33606-1966 Ph: (813) 258-6051 |