| |
669a W Lumsden Rd, Brandon, FL 33511-5911 | |
(813) 654-3354 | |
(813) 653-9177 |
Full Name | |
---|---|
Type | Facility |
Speciality | Non-pharmacy Dispensing Site |
Location | 669a W Lumsden Rd, Brandon, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437745015 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213EP1101X | Podiatrist - Primary Podiatric Medicine | (* (Not Available)) | Secondary |
332900000X | Non-pharmacy Dispensing Site | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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1401 16th St N, St Petersburg, FL 33704-4123 Ph: (727) 894-0794 | 669a W Lumsden Rd, Brandon, FL 33511-5911 Ph: (813) 654-3354 |