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NPI Code Detail

MEDICARE: DR. LANCE WYBLE MD

MEDICARE: DR. LANCE WYBLE MD
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
12080N0001XNeonatal-Perinatal Medicine PhysicianME50954FL

General Provider Information

NPI Number : 1861455610
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LANCE WYBLE MD
Provider Business Mailing Address
First Line : 3030 W DR MLKING JR BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33607-1165
Country : US
Telephone Number : 813-872-2924
Fax Number :
Provider Business Practice Location Address
First Line : 3030 W DR MARTIN LUTHER KING JR BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33607-6308
Country : US
Telephone Number : 813-872-2924
Fax Number : 813-879-4264
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2006
Last Update Date : 07/08/2007

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Directions to “ DR. LANCE WYBLE MD” Practice Location

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