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General NPI Number Information
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NPI Number | 1922269463
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Entity Type | Individual
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Provider Name | MS. THERESA ANN PACE
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Gender | Female
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 9056 HICKORY CIR
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City | TAMPA
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State | FL
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Zip | 33615-1441
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Country | US
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Telephone | 813-610-1562
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Fax | 813-884-8898
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Provider Business Mailing Address
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Address Line | PO BOX 261844
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City | TAMPA
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State | FL
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Zip | 33685-1844
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Country | US
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Telephone | 813-610-1562
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Fax | 813-884-8898
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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