National Provider Identifier Database

MAIN ST MEDICAL USA
Addiction Medicine

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.


Contact Information

MAIN ST MEDICAL USA
11734 NORTH DALE MABRY
TAMPA, FL33618
Phone: 813-968-6000
Fax: 813-968-6007
Website:
Specialty Taxonomy Code
* Addiction Medicine 207RA0401X
Internal Medicine 207R00000X
Pain Medicine 208VP0000X

* Indicates primary specialty

NPI Profile & details for MAIN ST MEDICAL USA

NPI Number 1003039033
Legal business name
LBN
MAIN ST MEDICAL USA
Authorized official STEPHEN STEFANO - (DIRECTOR MD)
Entity Organization
Organization subpart No
Enumeration date 04/10/2007
Last updated 09/24/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

Reviews for MAIN ST MEDICAL USA

There are currently no reviews for MAIN ST MEDICAL USA


NPIdb - Home
v2.201