Type 2 organization · NPI 1003039033
MAIN ST MEDICAL USA
207RA0401X · TAMPA, FL
Why this profile is appearing now
Observed change signals
No current public change signal is attached to this profile.
Reported classification
Taxonomies
| Code | Description | Source flag |
|---|---|---|
| 207RA0401X | 207RA0401X | Primary |
| 207R00000X | 207R00000X | Additional |
| 208VP0000X | 208VP0000X | Additional |
Taxonomy reporting does not establish licensure, board certification, expertise, or quality.
Longitudinal record
Observed change timeline
- 0 recorded field change s