| Shriners Healthcare For Children - Florida | |
|
12502 Usf Pine Dr Tampa FL 33612-9411 | |
| (813) 972-2250 | |
| Not Available |
| Full Name | Shriners Healthcare For Children - Florida |
|---|---|
| Speciality | Clinic/center |
| Location | 12502 Usf Pine Dr, Tampa, Florida |
| Authorized Official Name and Position | Jerry G. Gantt (PRESIDENT) |
| Authorized Official Contact | 8132810300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shriners Healthcare For Children - Florida Po Box 8500 Lockbox #7642 Philadelphia PA 19178-7642 Ph: (813) 281-0300 | Shriners Healthcare For Children - Florida 12502 Usf Pine Dr Tampa FL 33612-9411 Ph: (813) 972-2250 |
| NPI Number | 1477119170 |
|---|---|
| Provider Enumeration Date | 05/17/2019 |
| Last Update Date | 07/31/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477119170 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Secondary |
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