Organization
HUMANA MEDICAL PLAN INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI DUNNE (VICE PRESIDENT)
(813) 226-7199
Entity
Organization
Contact information
Practice address
4030 W BOY SCOUT BLVD FL 10, TAMPA, FL 33607-5713
(813) 226-7199
Mailing address
4030 W BOY SCOUT BLVD FL 10, TAMPA, FL 33607-5713
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100049901
—
FL
Enumeration date
10/20/2022
Last updated
10/20/2022
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