Main St Medical Usa
Addiction Medicine (Internal Medicine) Physician in Tampa, FL(View on Map)
Legal Business Name
Main St Medical Usa
NPI Number
1003039033
NPI Type
Organization
Enumeration Date
04/10/2007
Specialties
(Taxonomies)Name
Code
207RA0401X
207R00000X
208VP0000X
Primary Taxonomy
Yes
No
No
Contact
Information
Purpose
Mailing
Location
Address
11734 NORTH DALE MABRY
11734 NORTH DALE MABRY
City
Tampa
Tampa
State
FL
FL
Postal Code
33618
33618
Country
US
US
Telephone Number
(813) 968-6000
(813) 968-6000
Authorized Official
Name
Stephen Stefano
Title or Position
DIRECTOR MD
Telephone Number
(813) 968-6000
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 09/24/2013
Provider Address
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