Individual
DIANE MURRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13803 N FLORIDA AVE, TAMPA, FL 33613-3230
(813) 500-1899
Mailing address
6538 W HANNA AVE, TAMPA, FL 33634-4930
(813) 500-1899
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA75574
FL
Other
Enumeration date
04/24/2014
Last updated
04/24/2014
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