| |
15049 Bruce B Downs Blvd, Tampa, FL 33647-1388 | |
(937) 216-9048 | |
(844) 828-3997 |
Full Name | |
---|---|
Type | Facility |
Speciality | General Practice |
Location | 15049 Bruce B Downs Blvd, Tampa, Florida |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1962854802 | NPI | - | NPPES |
Provider Name | Paul D Anderson |
---|---|
Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1366738379 PECOS PAC ID: 8123336682 Enrollment ID: I20151001003025 |
Provider Name | Karen Abrams |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1861849648 PECOS PAC ID: 4880971100 Enrollment ID: I20170515000923 |
Provider Name | Monique R Wyche |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1447881404 PECOS PAC ID: 2567899198 Enrollment ID: I20200220002279 |
Provider Name | Jessica Lynne Moscoso |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548834450 PECOS PAC ID: 6800295882 Enrollment ID: I20210524002335 |
Provider Name | Isaac J Baime |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1326622077 PECOS PAC ID: 0840696779 Enrollment ID: I20210901001228 |
Mailing Address | Practice Location Address |
---|---|
15049 Bruce B Downs Blvd, Tampa, FL 33647-1388 Ph: (937) 216-9048 | 15049 Bruce B Downs Blvd, Tampa, FL 33647-1388 Ph: (937) 216-9048 |