Healthcare Provider Details

I. General information

NPI: 1760806517
Provider Name (Legal Business Name): MAGEE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2014
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12625 RACE TRACK RD WESTCHASE
TAMPA FL
33626-1331
US

IV. Provider business mailing address

12625 RACE TRACK RD WESTCHASE
TAMPA FL
33626-1331
US

V. Phone/Fax

Practice location:
  • Phone: 813-343-3960
  • Fax: 813-343-3965
Mailing address:
  • Phone: 813-343-3960
  • Fax: 813-343-3965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT21841
License Number StateFL

VIII. Authorized Official

Name: MR. JOHN PATRICK MAGEE
Title or Position: OWNER
Credential:
Phone: 813-343-3960