# PHYSICIAN ENTERPRISES PL

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

## Provider details

- **NPI number:** 1306132527
- **Authorized official:** DR. JOHN C BROCK MD (MANAGING MEMBER)
- **Authorized official phone:** (813) 839-6299

## Contact information

- **Practice address:** 3007 W FAIR OAKS AVE, TAMPA, FL 33611-1640
- **Practice address phone:** (813) 839-6299
- **Practice address fax:** (813) 839-4939
- **Mailing address:** 3007 W FAIR OAKS AVE, TAMPA, FL 33611-1640
- **Mailing address phone:** (813) 839-6299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | ME41814 | FL | Yes |

## Other

- **Enumeration date:** 06/27/2011
- **Last updated:** 06/27/2011