MEDICARE: CREIGHTON HEALTH CARE INC

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
1	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	0038694	FL

General Provider Information

NPI Number	:	1558402479
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CREIGHTON HEALTH CARE INC

Provider Business Mailing Address
First Line	:	9724 N ARMENIA AVE
Second Line	:	SUITE 100
City	:	TAMPA
State	:	FL
Zip	:	33612-7550
Country	:	US
Telephone Number	:	813-915-8666
Fax Number	:	813-930-9536

Provider Business Practice Location Address
First Line	:	9724 N ARMENIA AVE
Second Line	:	SUITE 100
City	:	TAMPA
State	:	FL
Zip	:	33612-7550
Country	:	US
Telephone Number	:	813-915-8666
Fax Number	:	813-930-9536

Authorized Official
Title or Position	:	MANAGER
Name	:	TARA DEJESUS
Credential	:
Telephone Number	:	813-915-8666

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1033498407 — MR. COLIN W FITZGERALD
Practice Location Address:

9724 N ARMENIA AVE , SUITE 100
TAMPA, FL
33612-7550

Practice Phone: 813-915-8666
Practice Fax:

1871844654 — PHU TRAN D.C.
Practice Location Address:

9724 N ARMENIA AVE STE 400
TAMPA, FL
33612-7550

Practice Phone: 813-530-9300
Practice Fax: 813-933-0968

1023454170 — MR. RONALD E. ANDERSON L.AC.
Practice Location Address:

9724 N ARMENIA AVE STE 400
TAMPA, FL
33612-7550

Practice Phone: 813-464-0967
Practice Fax: 813-933-0968

1902215544 — DR. CLARA SMITH CREIGHTON M.D.
Practice Location Address:

9724 N ARMENIA AVE , STE 100
TAMPA, FL
33612-7550

Practice Phone: 813-915-8666
Practice Fax: 813-930-9536

1164828596 — KENNETH HUYNH
Practice Location Address:

9724 N ARMENIA AVE
TAMPA, FL
33612-7550

Practice Phone: 813-464-0967
Practice Fax:

1255720595 — ANNA HEALTH, LLC.
Practice Location Address:

9724 N ARMENIA AVE , SUITE 400
TAMPA, FL
33612-7550

Practice Phone: 813-464-0967
Practice Fax:

Directions to “CREIGHTON HEALTH CARE INC ” 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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.