Provider First Line Business Practice Location Address:
601 E KENNEDY BLVD
Provider Second Line Business Practice Location Address:
AGING SERVICES, 25TH FLOOR
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33602-4156
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-272-5242
Provider Business Practice Location Address Fax Number:
813-272-6862
Provider Enumeration Date:
07/12/2007