Provider Demographics
NPI:1245062926
Name:UNDERWOOD, ADRIANNA ARNELLA
Entity type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:ARNELLA
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11806 BRUCE B DOWNS BLVD # 1444
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-5542
Mailing Address - Country:US
Mailing Address - Phone:813-420-0124
Mailing Address - Fax:
Practice Address - Street 1:1703 UNIVERSITY WOODS PL
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-2504
Practice Address - Country:US
Practice Address - Phone:813-420-0124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities