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Organization
SUPPORT ASSOCIATES OF TAMPA BAY, INC
Active
Organization
SUPPORT ASSOCIATES OF TAMPA BAY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNDA R DEBENEDET (CO OWNER)
(813) 908-6773
Entity
Organization
Contact information
Practice address
16112 N FLORIDA AVE, LUTZ, FL 33549-6129
(813) 908-6773
(813) 908-0423
Mailing address
16112 N FLORIDA AVE, LUTZ, FL 33549-6129
(813) 908-6773
(813) 908-0423
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002353400
—
FL
05
—
678755096
—
FL
Enumeration date
09/03/2014
Last updated
09/03/2014
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