Organization
GREATER TAMPA BAY PHYSICIAN SPECIALISTS, LLC
Active
Parent organization
GREATER TAMPA BAY PHYSICIAN SPECIALISTS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREATER TAMPA BAY PHYSICIAN SPECIALISTS, LLC
Authorized official
WILLIAM TEDRICK JOHNSON (VICE PRESIDEN)
(615) 372-3375
Entity
Organization
Contact information
Practice address
6006 49TH ST N STE 310, SAINT PETERSBURG, FL 33709-2149
(727) 289-7137
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4692
(615) 372-5426
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
09/17/2021
Last updated
09/17/2021
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