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NPI Code Detail

MEDICARE: DIGESTIVE DISEASES ASSOCIATES OF TAMPA BAY

MEDICARE: DIGESTIVE DISEASES ASSOCIATES OF TAMPA BAY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician

General Provider Information

NPI Number : 1114105400
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIGESTIVE DISEASES ASSOCIATES OF TAMPA BAY
Provider Business Mailing Address
First Line : 876 S PARSONS AVE
Second Line :
City : BRANDON
State : FL
Zip : 33511-6007
Country : US
Telephone Number : 813-653-3359
Fax Number :
Provider Business Practice Location Address
First Line : 876 S PARSONS AVE
Second Line :
City : BRANDON
State : FL
Zip : 33511-6007
Country : US
Telephone Number : 813-653-3359
Fax Number :
Authorized Official
Title or Position : PRACTICE MANAGER
Name : COLLEEN CORMAN
Credential :
Telephone Number : 813-653-3359
Provider Enumeration Date : 02/08/2008
Last Update Date : 03/24/2008

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Directions to “DIGESTIVE DISEASES ASSOCIATES OF TAMPA BAY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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