Provider First Line Business Practice Location Address: 
300 PINELLAS ST
    Provider Second Line Business Practice Location Address: 
    Provider Business Practice Location Address City Name: 
CLEARWATER
    Provider Business Practice Location Address State Name: 
FL
    Provider Business Practice Location Address Postal Code: 
33756
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
727-462-7000
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
04/22/2011