Provider First Line Business Practice Location Address:
3012 US HWY 301 N
Provider Second Line Business Practice Location Address:
UNIVERSITY COMMUNITY HOSPITAL STE 100
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-615-7676
Provider Business Practice Location Address Fax Number:
813-615-7677
Provider Enumeration Date:
06/06/2007