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Organization
VIJAY DIWADKAR,M.D.PA
Active
Organization
VIJAY DIWADKAR,M.D.PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAY DIWADKAR M.D. (MEDICAL DIRECTOR)
(813) 237-2500
Entity
Organization
Contact information
Practice address
701 W M.L.KING JR. BLVD., SUITE 3, TAMPA, FL 33603-3100
(813) 237-2500
(813) 237-2871
Mailing address
701 W M.L.KING BLVD, SUITE 3, TAMPA, FL 33603-1922
(813) 237-2500
(813) 237-2871
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
ME39294
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066699800
—
FL
01
—
30476
BCBS
FL
Enumeration date
11/12/2010
Last updated
12/01/2010
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