Healthcare Provider Details

I. General information

NPI: 1801068366
Provider Name (Legal Business Name): DAMON R REED MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 03/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12902 USF MAGNOLIA DR FOB1 SARCOMA PROGRAM
TAMPA FL
33612-9416
US

IV. Provider business mailing address

12902 USF MAGNOLIA DR FOB 1, SARCOMA PROGRAM
TAMPA FL
33612-9416
US

V. Phone/Fax

Practice location:
  • Phone: 813-745-3242
  • Fax: 813-745-8337
Mailing address:
  • Phone: 813-745-3242
  • Fax: 813-745-8337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number40305
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberME101596
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: