# WEST COAST MEDICINE OF TAMPA BAY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568656429
- **Authorized official:** DR. MARK GEORGE KANTZLER D.O. (OWNER)
- **Authorized official phone:** (727) 458-3011

## Contact information

- **Practice address:** 1155 S DALE MABRY HWY, \#19, TAMPA, FL 33629-5035
- **Practice address phone:** (727) 458-3011
- **Mailing address:** PO BOX 1619, LARGO, FL 33779-1619
- **Mailing address phone:** (727) 458-3011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OS5165 | FL | Yes |

## Other

- **Enumeration date:** 09/04/2007
- **Last updated:** 02/08/2012