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General NPI Number Information
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NPI Number | 1225331564
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Entity Type | Organization
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Legal Business Name | VETERANS ADMINISTRATION
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Dates
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Enumeration Date | 12/08/2010
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 9500 BAY PINES BLVD
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City | BAY PINES
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State | FL
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Zip | 33744-8700
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Country | US
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Telephone | 727-398-6661
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Fax | 727-398-9581
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Provider Business Mailing Address
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Address Line | 10000 BAY PINES BLVD
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City | BAY PINES
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State | FL
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Zip | 33744
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Country | US
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Telephone | 727-398-6661
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Fax | 727-398-9581
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | ASHLEY AUGUSTE
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Credential | MSW
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Telephone | 727-398-6661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 286500000X
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Taxonomy Name | Military Hospital
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License Number |
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License Number State |
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