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Life Medical Group, Llc
General Practice Physician in Lutz, Florida
NPI 1922441054

Life Medical Group, Llc is a General Practice Physician based in Lutz, FL. Life Medical Group, Llc practices in Lutz, FL. The NPI Number for Life Medical Group, Llc is 1922441054 and holds a License No. ME82833 (Florida).

The current practice location address for Life Medical Group, Llc is 14614 Livingston Ave, Lutz, FL and can be reached out via phone at 813-972-7979 and via fax at 813-972-2424.

Location: 14614 Livingston Ave, Lutz, FL, 33559-3101
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1922441054
Provider Name
Life Medical Group, Llc
Credential
Provider Entity Type
Organization
Address
14614 Livingston Ave, Lutz, FL, 33559-3101
Phone Number
813-972-7979
Fax Number
813-972-2424
Provider Enumeration Date
04/08/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
12523258 01 FL CAQH
institution
Provider Business Practice Location Address Details
Address
14614 Livingston Ave
City
Lutz
State
Florida
Zip
33559-3101
Phone Number
813-972-7979
Fax Number
813-972-2424
person
Provider Business Mailing Address Details
Address
14614 Livingston Ave
City
Lutz
State
Florida
Zip
33559-3101
Phone Number
813-972-7979
Fax Number
813-972-2424
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
ME82833 (Florida)
Definition
Definition to come...
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