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NPI Code Detail

MEDICARE: SPECTRE TELEHEALTH

MEDICARE: SPECTRE TELEHEALTH
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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1184213118
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPECTRE TELEHEALTH
Provider Business Mailing Address
First Line : 401 E JACKSON ST STE 2340
Second Line :
City : TAMPA
State : FL
Zip : 33602-5226
Country : US
Telephone Number : 352-238-6751
Fax Number :
Provider Business Practice Location Address
First Line : 401 E JACKSON ST STE 2340
Second Line :
City : TAMPA
State : FL
Zip : 33602-5226
Country : US
Telephone Number : 352-238-6751
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : WILLIAM BALSAMO
Credential :
Telephone Number : 352-238-6751
Provider Enumeration Date : 01/14/2021
Last Update Date : 01/14/2021

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Directions to “SPECTRE TELEHEALTH ” 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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