Individual
ELAINE ROUCO PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6822 W WATERS AVE, TAMPA, FL 33634-2212
(813) 280-4909
(813) 302-7143
Mailing address
6822 W WATERS AVE, TAMPA, FL 33634-2212
(813) 280-4909
(813) 302-7143
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9109133
FL
Other
Enumeration date
10/20/2015
Last updated
08/29/2024
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