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Organization
KETAMINE123LLC
Active
Organization
KETAMINE123LLC
Active
Other names
Ketamine Solutions of Tampa
Organization subpart
No
Provider details
NPI number
Authorized official
CLINT FLETCHER CRNA (OWNER)
(615) 300-3096
Entity
Organization
Contact information
Practice address
3450 E FLETCHER AVE STE 300, TAMPA, FL 33613-4659
(813) 632-3223
(813) 632-3224
Mailing address
3450 E FLETCHER AVE STE 300, TAMPA, FL 33613-4659
(813) 632-3223
(813) 632-3224
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/20/2021
Last updated
11/10/2021
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