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Organization
WEST COAST MEDICINE OF TAMPA BAY, LLC
Active
Organization
WEST COAST MEDICINE OF TAMPA BAY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK GEORGE KANTZLER D.O. (OWNER)
(727) 458-3011
Entity
Organization
Contact information
Practice address
1155 S DALE MABRY HWY, #19, TAMPA, FL 33629-5035
(727) 458-3011
Mailing address
PO BOX 1619, LARGO, FL 33779-1619
(727) 458-3011
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS5165
FL
Other
Enumeration date
09/04/2007
Last updated
02/08/2012
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