Mildred Catherine Conneely
General Practice Physician
1701 W Jetton Ave
Tampa
, Florida 33606-3026
Mildred Catherine Conneely
General Practice Physician
1701 W Jetton Ave
Tampa
, Florida 33606-3026
(813) 786-6364
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Mildred Catherine Conneely
- 1701 W Jetton Ave
- Tampa, FL
- Zip : 33606-3026
- Phone : (813) 786-6364
Second Address
- Mildred Catherine Conneely
- 1701 W Jetton Ave
- Tampa, FL
- Zip : 33606-3026
- Phone : (813) 786-6364
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208D00000X | General Practice Physician | F02180856 | FL |
National Provider Identifier
| NPI | 1023507407 |
|---|---|
| Provider Name | Mildred Catherine Conneely |
| First Address | Tampa, FL 33606-3026 |
| Second Address | Tampa, FL 33606-3026 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/05/2018 |
| Last Update Date | 01/05/2018 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.