Individual
COLLIN BUCHANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3715 E POWHATAN AVE, TAMPA, FL 33610-3726
(813) 523-5963
Mailing address
3715 E POWHATAN AVE, TAMPA, FL 33610-3726
(813) 523-5963
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6907064
FL
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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