Individual
HEATHER C BRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
12902 MAGNOLIA DR, SRB4, TAMPA, FL 33612
(813) 745-7853
Mailing address
12902 MAGNOLIA DR, SRB4, TAMPA, FL 33612
(813) 745-7853
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PAT9104498
FL
Other
Enumeration date
02/20/2008
Last updated
01/14/2011
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