Provider First Line Business Practice Location Address:
10921 N. DALE MABRY
Provider Second Line Business Practice Location Address:
SHILOH MEDICAL CENTER
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-341-4000
Provider Business Practice Location Address Fax Number:
813-341-4001
Provider Enumeration Date:
02/15/2006