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General NPI Number Information
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NPI Number | 1093671745
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Entity Type | Organization
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Legal Business Name | BYGRACE HEALTHCARE SERVICES
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Dates
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Enumeration Date | 12/26/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 7402 N 56TH ST STE 355
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City | TAMPA
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State | FL
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Zip | 33617-7700
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Country | US
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Telephone | 813-504-6804
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Fax |
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Provider Business Mailing Address
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Address Line | 7402 N 56TH ST STE 355
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City | TAMPA
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State | FL
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Zip | 33617-7700
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DAVID HERNANDEZ ECHAZABAL
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Credential | PA
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Telephone | 813-850-6307
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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