PHYSICIAN ENTERPRISES PL
Radiology at Fair Oaks Ave, Tampa, FL

License number
Florida ME41814
Category
Radiology
Type
Thoracic Surgery (Cardiothoracic Vascular Surgery)
Owner
Name: DR. JOHN C BROCK MD
Title: MANAGING MEMBER
Phone: (813) 839-6299
Address
Address
3007 W Fair Oaks Ave, Tampa, FL 33611
National Provider ID: 1306132527
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PHYSICIAN ENTERPRISES, P.L

3007 W Fair Oaks Ave, Tampa, FL 33611

Industry:
Business Services
Registration:
May 25, 2011
State ID:
L11000062061
Business type:
Florida Limited Liability Company
Manager:
John Cm.d. Brock (Manager), 3007 W Fair Oaks Ave, Tampa, FL 33611 (Physical)
Agent:
Erin Aebel,101 E Kennedy Blvd SUITE 2800, Tampa, FL 33602 (Physical)
EIN:
80-0731613

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