Provider First Line Business Practice Location Address:
6000 49TH ST. N.
Provider Second Line Business Practice Location Address:
NORTHSIDE HOSPITAL
Provider Business Practice Location Address City Name:
ST PETERSBURG
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-521-5524
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/09/2007