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Individual

MS. THERESA ANN PACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9056 HICKORY CIR, TAMPA, FL 33615-1441
(813) 610-1562
(813) 884-8898
Mailing address
PO BOX 261844, TAMPA, FL 33685-1844
(813) 610-1562
(813) 884-8898

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
679802196
FL
05
679802198
FL
Enumeration date
06/18/2008
Last updated
06/18/2008
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