Organization
UNIVERSITY COMMUNITY HOSPITAL LTAC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLIS B. NORSOPH M.D. (PRESIDENT)
(813) 899-6220
Entity
Organization
Contact information
Practice address
9441 HEALTH CENTER DR, LAND O LAKES, FL 34637-5837
(819) 899-6226
(819) 985-8006
Mailing address
PO BOX 23057, TAMPA, FL 33623-2057
(819) 899-6226
(819) 985-8006
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4499
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4499
STATE LICENCE
FL
Enumeration date
09/27/2010
Last updated
09/27/2010
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