Individual
PHYLLIS THOMAS POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
1310 FOUR SEASONS BLVD, TAMPA, FL 33613-2326
(813) 803-0315
Mailing address
1310 FOUR SEASONS BLVD, TAMPA, FL 33613-2326
(813) 803-0315
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
L16000017965
FL
Other
Enumeration date
09/30/2016
Last updated
09/30/2016
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