Organization
ANISTA WESTCHASE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JERRI LYNN DERBYSHIRE (OFFICE MANAGER)
(813) 695-4843
Entity
Organization
Contact information
Practice address
10718 COUNTRYWAY BLVD, TAMPA, FL 33626-1733
(813) 855-4000
Mailing address
10718 COUNTRYWAY BLVD, TAMPA, FL 33626-1733
(813) 855-4000
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
FL
Other
Enumeration date
08/07/2011
Last updated
08/14/2011
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