Organization
TAMPA HEALTHY AGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY GRANELL PH.D., D.O (OWNER)
(813) 963-7500
Entity
Organization
Contact information
Practice address
15417 N DALE MABRY HWY, TAMPA, FL 33618-1822
(813) 963-7500
Mailing address
15417 N DALE MABRY HWY, TAMPA, FL 33618-1822
(813) 963-7500
(813) 963-7551
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OS 5939
FL
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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