Provider Demographics
NPI:1518115633
Name:PHILIPS, TWYLA (AP)
Entity Type:Individual
Prefix:
First Name:TWYLA
Middle Name:
Last Name:PHILIPS
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 MAPLECREST PLACE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-1527
Mailing Address - Country:US
Mailing Address - Phone:813-732-3122
Mailing Address - Fax:
Practice Address - Street 1:3401 W COLUMBUS DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1869
Practice Address - Country:US
Practice Address - Phone:813-341-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1649171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist