Individual
TATIA GRANT LEVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3100 E FLETCHER AVE, EMERGENCY DEPT, TAMPA, FL 33613-4613
(813) 971-6000
(813) 615-7590
Mailing address
12479 TELECOM DR, TAMPA, FL 33637-0913
(813) 972-4199
(813) 972-5753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
OS7331
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267036400
—
FL
01
—
78698
BCBS
FL
01
—
P00041157
RRMCR
FL
Enumeration date
09/22/2005
Last updated
12/31/2014
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