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General NPI Number Information
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NPI Number | 1194042184
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH'S HOSPITAL TAMPA CARE CLINIC
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Dates
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Enumeration Date | 04/29/2010
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 2123 W DR MARTIN LUTHER KING JR BLVD STE 201
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City | TAMPA
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State | FL
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Zip | 33607-6545
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Country | US
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Telephone | 813-870-4460
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Fax | 813-870-4459
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Provider Business Mailing Address
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Address Line | 2123 W DR MARTIN LUTHER KING JR BLVD STE 201
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City | TAMPA
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State | FL
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Zip | 33607-6545
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Country | US
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Telephone | 813-870-4460
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Fax | 813-870-4459
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Authorized Official
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Title or Position | CASE MANAGER
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Name | MS. MARY F JONES
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Credential | BA
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Telephone | 813-870-4460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | FL
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