Healthcare Provider Details

I. General information

NPI: 1760823918
Provider Name (Legal Business Name): TENDERCARE PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2013
Last Update Date: 07/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27432 CASHFORD CIR STE 102
WESLEY CHAPEL FL
33544-6916
US

IV. Provider business mailing address

27432 CASHFORD CIR STE 102
WESLEY CHAPEL FL
33544-6916
US

V. Phone/Fax

Practice location:
  • Phone: 813-973-9900
  • Fax: 813-973-9982
Mailing address:
  • Phone: 813-973-9900
  • Fax: 813-973-9982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME85950
License Number StateFL

VIII. Authorized Official

Name: JOYCE STONE
Title or Position: PRACTICE ADMIN
Credential:
Phone: 813-973-9900