Basic Information
| Provider Information | |||||||||
| NPI: | 1407889595 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SENSENBRENNER | ||||||||
| FirstName: | LYLE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4519 GEORGE RD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336347329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134961075 | ||||||||
| FaxNumber: | 8132497762 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 B E. VINE ST | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134961075 | ||||||||
| FaxNumber: | 8132497762 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | D10503 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.