Individual
HEBRON BANCROFT WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
(813) 971-6000
Mailing address
12479 TELECOM DR, TEMPLE TERRACE, FL 33637-0913
(813) 972-4199
(813) 972-5753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME111009
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008968100
—
FL
01
—
14R14
BCBSF
FL
Enumeration date
10/26/2011
Last updated
03/25/2014
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