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Organization
PHYSICIAN ENTERPRISES PL
Active
Organization
PHYSICIAN ENTERPRISES PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN C BROCK MD (MANAGING MEMBER)
(813) 839-6299
Entity
Organization
Contact information
Practice address
3007 W FAIR OAKS AVE, TAMPA, FL 33611-1640
(813) 839-6299
(813) 839-4939
Mailing address
3007 W FAIR OAKS AVE, TAMPA, FL 33611-1640
(813) 839-6299
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME41814
FL
Other
Enumeration date
06/27/2011
Last updated
06/27/2011
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