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General NPI Number Information
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NPI Number | 1386878056
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Entity Type | Organization
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Legal Business Name | STERN, DRAKE, ISBELL AND ASSOCS PA
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 4516 N ARMENIA AVE
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City | TAMPA
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State | FL
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Zip | 33603-2732
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Country | US
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Telephone | 813-348-6950
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Fax | 813-348-6999
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Provider Business Mailing Address
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Address Line | 4516 N ARMENIA AVE
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City | TAMPA
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State | FL
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Zip | 33603-2732
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Country | US
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Telephone | 813-348-6950
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Fax | 813-348-6999
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JEFF A YOUNGER
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Credential | FACHE
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Telephone | 813-348-6952
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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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 | 2085B0100X
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Taxonomy Name | Body Imaging Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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