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Organization
ETHOS HEALTH TAMPA 4 LLC
Active
Organization
ETHOS HEALTH TAMPA 4 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN WALKER (OWNER/OPERATOR)
(352) 732-5590
Entity
Organization
Contact information
Practice address
710 OAKFIELD DR STE 105, BRANDON, FL 33511-4931
(352) 732-5590
(352) 732-0292
Mailing address
1541 SE 17TH ST, OCALA, FL 34471-4607
(352) 732-5590
(352) 732-0292
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/31/2018
Last updated
08/09/2021
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