Provider First Line Business Practice Location Address:
1200 S. PINELLAS AVE # 11
Provider Second Line Business Practice Location Address:
JSA TARPON SOUTH PRIMARY CARE CENTER
Provider Business Practice Location Address City Name:
TARPON SPRINGS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34689-3716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-942-8900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/22/2006