Provider First Line Business Practice Location Address:
BPVAMC/SURGICAL SERVICE (112)
Provider Second Line Business Practice Location Address:
10,000 BAY PINES BLVD
Provider Business Practice Location Address City Name:
BAY PINES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33744
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-398-9385
Provider Business Practice Location Address Fax Number:
727-398-9584
Provider Enumeration Date:
10/16/2006