Organization
STATPA-C INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN LAYTON PHYSICIAN ASSISTANT (CEO)
(813) 802-9969
Entity
Organization
Contact information
Practice address
5604 GLEN CREST BLVD, TAMPA, FL 33625-1001
(813) 802-9969
Mailing address
5604 GLEN CREST BLVD, TAMPA, FL 33625-1001
(813) 802-9969
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9100648
FL
Other
Enumeration date
10/29/2012
Last updated
10/29/2012
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