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General NPI Number Information
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NPI Number | 1265248579
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Entity Type | Organization
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Legal Business Name | DOCTOR DOCTOR ON-CALL
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 2314 E 22ND AVE
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City | TAMPA
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State | FL
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Zip | 33605-2067
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Country | US
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Telephone | 813-597-1758
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Fax | 813-706-6612
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Provider Business Mailing Address
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Address Line | PO BOX 75496
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City | TAMPA
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State | FL
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Zip | 33675-0496
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Country | US
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Telephone | 813-597-1758
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HENRIA M FAIN
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Credential | MD, DPT, ATC
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Telephone | 813-743-4383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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