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Specialty details in registry · Tampa, FL

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At a glance

1441 E Fletcher Ave, Tampa, FL 33612-3633

NPPES record updated Feb 10, 2026. Public records can lag behind changes at a practice.

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Practice location

1441 E Fletcher Ave
Tampa, FL 33612-3633

Professional details: NPI, taxonomy & registry record

NPI1588516926

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 332B00000X
Enumeration date: Feb 10, 2026
Record updated: Feb 10, 2026

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

332B00000X · Primary

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

Practice location

1441 E Fletcher Ave
Tampa, FL 33612-3633

Phone: (813) 265-2520
Fax: (813) 264-5931

Mailing address

409 MONTGOMERY RD STE 161

ALTAMONTE SPRINGS, FL 327146826

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

Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.

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