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NPI Code Detail

MEDICARE: ALPHA BRIDGE CONNECTIONS, LLC

MEDICARE: ALPHA BRIDGE CONNECTIONS, LLC
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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
7CK8272OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1007530458OTHERFLAETNA
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
334616OTHERFLBLUE CROSS BLUE SHIELD
4038U0ALOTHERMNBLUE CROSS BLUE SHIELD MN
5001500049OTHERHIGHMARK BCBS
6CK4226OTHERUNITED AMERICAN
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194706051
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALPHA BRIDGE CONNECTIONS, LLC
Provider Business Mailing Address
First Line : 10150 HIGHLAND MANOR DR
Second Line : SUITE 300
City : TAMPA
State : FL
Zip : 33610-9712
Country : US
Telephone Number : 813-558-6500
Fax Number : 813-558-6572
Provider Business Practice Location Address
First Line : 10150 HIGHLAND MANOR DR
Second Line : SUITE 300
City : TAMPA
State : FL
Zip : 33610-9712
Country : US
Telephone Number : 813-558-6500
Fax Number : 813-558-6572
Authorized Official
Title or Position : PRESIDENT
Name : MRS. MARILYN G WOOD
Credential :
Telephone Number : 813-558-6561
Provider Enumeration Date : 11/08/2005
Last Update Date : 07/25/2012

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Directions to “ALPHA BRIDGE CONNECTIONS, LLC ” Practice Location

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