Individual
COLIN D AGERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3250 ZEMKE AVE, TAMPA, FL 33621-5023
(813) 978-9700
Mailing address
3250 ZEMKE AVE, TAMPA, FL 33621-5023
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9105738
FL
363AS0400X
Surgical Physician Assistant
PA9105738
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004380300
—
FL
01
—
PA9105738
STATE LICENSE
FL
01
—
Y09H3
BCBS
FL
Enumeration date
10/19/2010
Last updated
07/31/2025
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