Contract Details
Ancillary Care Services
Facility name
All Podiatry Group
Provider ID
P000004536
NPI
1437207933
Tax ID
593509645
Effective Date
4/1/2012
Last Updated
10/2/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
2511 West Dr. MLK, Jr. Boulevard
Tampa, FL 33607
United States
County
Hillsborough
Phone
8138797850 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Podiatry
Map
Address