Provider Demographics
NPI:1720494024
Name:FOCUS-FL 1012 PLLC
Entity Type:Organization
Organization Name:FOCUS-FL 1012 PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-225-3542
Mailing Address - Street 1:510 LORNA SQ
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35216-5480
Mailing Address - Country:US
Mailing Address - Phone:877-225-3542
Mailing Address - Fax:877-638-9903
Practice Address - Street 1:1501 S DALE MABRY HWY STE A6
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5837
Practice Address - Country:US
Practice Address - Phone:877-225-3542
Practice Address - Fax:877-638-9903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty