Individual
JUSTIN LEWIS PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 TAMPA GENERAL CIRCLE, TAMPA, FL 33606-3603
(813) 974-2201
(813) 974-4280
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME112553
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005638600
—
FL
01
—
14L03
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/17/2007
Last updated
03/31/2021
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