# CREIGHTON HEALTH CARE INC

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

## Provider details

- **NPI number:** 1558402479
- **Authorized official:** TARA DEJESUS (MANAGER)
- **Authorized official phone:** (813) 915-8666

## Contact information

- **Practice address:** 9724 N ARMENIA AVE, SUITE 100, TAMPA, FL 33612-7550
- **Practice address phone:** (813) 915-8666
- **Practice address fax:** (813) 930-9536
- **Mailing address:** 9724 N ARMENIA AVE, SUITE 100, TAMPA, FL 33612-7550
- **Mailing address phone:** (813) 915-8666
- **Mailing address fax:** (813) 930-9536

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | 0038694 | FL | Yes |

## Other

- **Enumeration date:** 02/12/2007
- **Last updated:** 08/22/2020