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Specialty details in registry · Tampa, FL

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At a glance

5428 Deerbrooke Creek Cir Apt 8, Tampa, FL 33624-4157

NPPES record updated May 23, 2026. Public records can lag behind changes at a practice.

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Practice location

5428 Deerbrooke Creek Cir Apt 8
Tampa, FL 33624-4157

Professional details: NPI, taxonomy & registry record

NPI1194655704

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 343900000X
Enumeration date: May 23, 2026
Record updated: May 23, 2026

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

343900000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

5428 Deerbrooke Creek Cir Apt 8
Tampa, FL 33624-4157

Phone: (813) 403-8483

Mailing address

5428 DEERBROOKE CREEK CIR

TAMPA, FL 336242865

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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