Provider First Line Business Practice Location Address:
401 W. KENNEDY BLVD
Provider Second Line Business Practice Location Address:
UNIVERSITY OF TAMPA
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-253-6250
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/21/2008