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General NPI Number Information
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NPI Number | 1194706051
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Entity Type | Organization
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Legal Business Name | ALPHA BRIDGE CONNECTIONS, LLC
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 07/25/2012
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Provider Practice Location Address
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Address Line | 10150 HIGHLAND MANOR DR SUITE 300
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City | TAMPA
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State | FL
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Zip | 33610-9712
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Country | US
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Telephone | 813-558-6500
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Fax | 813-558-6572
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Provider Business Mailing Address
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Address Line | 10150 HIGHLAND MANOR DR SUITE 300
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City | TAMPA
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State | FL
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Zip | 33610-9712
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Country | US
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Telephone | 813-558-6500
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Fax | 813-558-6572
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARILYN G WOOD
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Credential |
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Telephone | 813-558-6561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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