Organization
DWIC OF TAMPA BAY, INC
Active
Other names
MedExpress - Bloomin Brands Tampa
Organization subpart
No
Provider details
NPI number
Authorized official
JOY KIMBALL (CONTRACT MANAGER)
(763) 349-6740
Entity
Organization
Contact information
Practice address
2202 N WEST SHORE BLVD STE 500, TAMPA, FL 33607-5754
(813) 282-1225
Mailing address
423 FORTRESS BLVD, MORGANTOWN, WV 26508-1351
(304) 225-2500
(304) 985-6350
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/28/2018
Last updated
05/07/2024
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