Provider First Line Business Practice Location Address:
13000 BRUCE B DOWNS
Provider Second Line Business Practice Location Address:
JAMES A HALEY VA HOSPITAL
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-903-3613
Provider Business Practice Location Address Fax Number:
813-631-7131
Provider Enumeration Date:
03/09/2007