Provider First Line Business Practice Location Address:
12880 COMMODITY PL
Provider Second Line Business Practice Location Address:
CARE OF USA SURGICAL SERVICES CT, P.C.
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33626-3101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-872-5788
Provider Business Practice Location Address Fax Number:
866-698-7272
Provider Enumeration Date:
07/27/2006