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Organization

CTM HEALTHCARE LLC

Active
Parent organization
INTERSTRIDE CORPORATION
Organization subpart
Yes

Provider details

NPI number
Legal business name
INTERSTRIDE CORPORATION
Authorized official
DR. COLLEEN C CAMPBELL MD (MEDICAL DIRECTOR)
(813) 200-7717
Entity
Organization

Contact information

Practice address
5503 E BUSCH BLVD, TEMPLE TERRACE, FL 33617-5419
(813) 200-7717
(813) 985-8500
Mailing address
5503 E BUSCH BLVD, TEMPLE TERRACE, FL 33617-5419
(813) 200-7717
(813) 985-8500

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME88894
FL

Other

Enumeration date
06/16/2010
Last updated
12/08/2011
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