Healthcare Provider Details

I. General information

NPI: 1992746879
Provider Name (Legal Business Name): AFTER HOURS PEDIATRICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 11/11/2020
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 COCONUT PALM DR STE 120
TAMPA FL
33619
US

IV. Provider business mailing address

3901 COCONUT PALM DR STE 120
TAMPA FL
33619-8362
US

V. Phone/Fax

Practice location:
  • Phone: 813-775-4030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GREGORY LEVY
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 813-775-4030