# TAMPA HEALTHY AGING, INC.

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

## Provider details

- **NPI number:** 1881002533
- **Authorized official:** ANTHONY GRANELL PH.D., D.O (OWNER)
- **Authorized official phone:** (813) 963-7500

## Contact information

- **Practice address:** 15417 N DALE MABRY HWY, TAMPA, FL 33618-1822
- **Practice address phone:** (813) 963-7500
- **Mailing address:** 15417 N DALE MABRY HWY, TAMPA, FL 33618-1822
- **Mailing address phone:** (813) 963-7500
- **Mailing address fax:** (813) 963-7551

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | OS 5939 | FL | Yes |

## Other

- **Enumeration date:** 07/25/2014
- **Last updated:** 07/25/2014