Individual
CORINNE MARY BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
(813) 812-8670
Mailing address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME161025
FL
207P00000X
Emergency Medicine Physician
T4621
TX
Other
Enumeration date
04/03/2020
Last updated
07/05/2023
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