Provider First Line Business Practice Location Address:
10000 BAY PINES BLVD
Provider Second Line Business Practice Location Address:
BAY PINES VA HEALTHCARE SYSTEM--BLDG 100-4C GI LAB
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-398-6661
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/23/2006