Provider First Line Business Practice Location Address:
4302 N. GOMEZ AVE
Provider Second Line Business Practice Location Address:
TAMPA EYE & SPECIALTY SURGERY CENTER
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-867-8898
Provider Business Practice Location Address Fax Number:
352-732-6282
Provider Enumeration Date:
05/05/2006