MAIN ST MEDICAL USA NPI 1003039033

NPI Information

MAIN ST MEDICAL USA is an addiction medicine internal medicine in Tampa, FL. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. MAIN ST MEDICAL USA NPI is 1003039033. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

11734 NORTH DALE MABRY
TAMPA, FL
ZIP 33618
Phone: (813) 968-6000
Fax: (813) 968-6007

The provider's authorized official is Stephen Allen Stefano .
The authorized official title is Director Md and has the following contact phone number (813) 968-6000.

The enumeration date for this NPI number is 4/10/2007 and was last updated on 9/24/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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