Healthcare Provider Details

I. General information

NPI: 1366468613
Provider Name (Legal Business Name): WILLIAM B ALBERTSON P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 E FLETCHER AVE SUITE 320
TAMPA FL
33613-4656
US

IV. Provider business mailing address

3000 E FLETCHER AVE SUITE 320
TAMPA FL
33613-4656
US

V. Phone/Fax

Practice location:
  • Phone: 813-910-0027
  • Fax: 813-971-1286
Mailing address:
  • Phone: 813-910-0027
  • Fax: 813-971-1286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA1604
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: