Healthcare Provider Details

I. General information

NPI: 1902873623
Provider Name (Legal Business Name): DANA ALAN CAMPBELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 06/12/2020
Certification Date: 06/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 CORBETT ST STE 250
BELLEAIR FL
33756-7310
US

IV. Provider business mailing address

401 CORBETT ST STE 250
BELLEAIR FL
33756-7310
US

V. Phone/Fax

Practice location:
  • Phone: 727-734-2485
  • Fax: 888-972-3760
Mailing address:
  • Phone: 727-734-2485
  • Fax: 888-972-3760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberME93564
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: