Organization
FIT4LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L HOWE (BILLING SUPERVISOR)
(813) 431-2633
Entity
Organization
Contact information
Practice address
17419 BRIDGE HILL CT, TAMPA, FL 33647
(813) 907-7879
(813) 994-3080
Mailing address
17419 BRIDGE HILL CT, TAMPA, FL 33647
(813) 907-7879
(813) 994-3080
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
HCC5580
FL
Other
Enumeration date
05/23/2007
Last updated
08/22/2020
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