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Vivant Medical Group Llc
General Practice Physician in Tampa, Florida
NPI 1124652425

Vivant Medical Group Llc is a General Practice Physician based in Tampa, FL. Vivant Medical Group Llc practices in Tampa, FL. The NPI Number for Vivant Medical Group Llc is 1124652425 and holds a License No. (Florida).

The current practice location address for Vivant Medical Group Llc is 6214 Memorial Hwy Ste B, Tampa, FL and can be reached out via phone at 800-574-9491 and via fax at 800-547-2802.

Location: 6214 Memorial Hwy Ste B, Tampa, FL, 33615-4507
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1124652425
Provider Name
Vivant Medical Group Llc
Credential
Provider Entity Type
Organization
Address
6214 Memorial Hwy Ste B, Tampa, FL, 33615-4507
Phone Number
800-574-9491
Fax Number
800-547-2802
Provider Enumeration Date
02/25/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
273932100 05 FL
institution
Provider Business Practice Location Address Details
Address
6214 Memorial Hwy Ste B
City
Tampa
State
Florida
Zip
33615-4507
Phone Number
800-574-9491
Fax Number
800-547-2802
person
Provider Business Mailing Address Details
Address
6214 Memorial Hwy Ste B
City
Tampa
State
Florida
Zip
33615-4507
Phone Number
800-574-9491
Fax Number
800-547-2802
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
()
Definition
Definition to come...
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