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NPI Code Detail

MEDICARE: RADLEY L GRIFFIN MD PL

MEDICARE: RADLEY L GRIFFIN MD PL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistME93435FL

General Provider Information

NPI Number : 1194908517
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADLEY L GRIFFIN MD PL
Provider Business Mailing Address
First Line : 2420 W MISSISSIPPI AVE
Second Line :
City : TAMPA
State : FL
Zip : 33629-6110
Country : US
Telephone Number : 813-350-9090
Fax Number : 833-941-2649
Provider Business Practice Location Address
First Line : 2420 W MISSISSIPPI AVE
Second Line :
City : TAMPA
State : FL
Zip : 33629-6110
Country : US
Telephone Number : 813-350-9090
Fax Number : 833-941-2649
Authorized Official
Title or Position : PHYSICIAN
Name : DR. RADLEY L GRIFFIN
Credential : M.D
Telephone Number : 813-350-9090
Provider Enumeration Date : 12/07/2007
Last Update Date : 08/11/2023

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