Organization
DOCTOR DOCTOR ON-CALL
Active
Other names
Henria M. Fain M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRIA M FAIN MD, DPT, ATC (OWNER)
(813) 743-4383
Entity
Organization
Contact information
Practice address
2314 E 22ND AVE, TAMPA, FL 33605-2067
(813) 597-1758
(813) 706-6612
Mailing address
PO BOX 75496, TAMPA, FL 33675-0496
(813) 597-1758
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121064700
—
FL
Enumeration date
12/10/2024
Last updated
12/10/2024
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