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Organization
YOUR PLACE HEALTH SYSTEM LLC
Active
Organization
YOUR PLACE HEALTH SYSTEM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYDEL Y LEGRANDE M.D, (OWNER)
(813) 443-0866
Entity
Organization
Contact information
Practice address
1793 W HILLSBOROUGH AVE, TAMPA, FL 33603-1130
(813) 443-0866
(813) 225-1583
Mailing address
1793 W HILLSBOROUGH AVE, TAMPA, FL 33603-1130
(813) 443-0866
(813) 225-1583
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME47234
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CY926A
P-TAN
FL
01
—
D44801
UPIN #
—
05
—
PENDING
—
FL
Enumeration date
09/18/2009
Last updated
10/28/2014
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