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Organization

BETH INGRAM & ASSOCIATES, LLC

Active
Other names
HealthPRO Pediatrics
Organization subpart
No

Provider details

NPI number
Authorized official
VANESSA BANKS (DIRECTOR OF OPERATIONS)
(813) 508-2991
Entity
Organization

Contact information

Practice address
1344 W FLETCHER AVE, TAMPA, FL 33612-3366
(813) 653-1149
(813) 654-6644
Mailing address
602 VONDERBURG DR STE 201, BRANDON, FL 33511-5900

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
225100000X
Physical Therapist
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000780900
FL
05
880065100
FL
05
880065102
FL
05
880065104
FL
05
880065105
FL
05
880065107
FL
01
ER761A
MEDICARE PTAN
FL
Enumeration date
05/25/2007
Last updated
06/06/2024
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