# ETHOS HEATH TAMPA 5LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225626054
- **Authorized official:** JONATHAN WALKER DC (OWNER)
- **Authorized official phone:** (352) 732-5590

## Contact information

- **Practice address:** 4710 N HABANA AVE STE 302, TAMPA, FL 33614-7151
- **Practice address phone:** (352) 732-5590
- **Practice address fax:** (352) 732-0292
- **Mailing address:** 4710 N HABANA AVE STE 302, TAMPA, FL 33614-7151
- **Mailing address phone:** (352) 732-5590
- **Mailing address fax:** (352) 732-0292

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/07/2021
- **Last updated:** 01/07/2021