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Individual

DR. MICHAEL BRUCE AUSTIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
6822 W WATERS AVE, TAMPA, FL 33634-2212
(813) 514-6460
Mailing address
PO BOX 262647, TAMPA, FL 33685-2647
(813) 787-4437

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OS005242
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
062239700
FL
Enumeration date
08/06/2006
Last updated
07/22/2009
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