Organization
VIVIFY PLASTIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALLAS R. BUCHANAN MD (OWNER/PROVIDER)
(833) 284-8439
Entity
Organization
Contact information
Practice address
1000 W KENNEDY BLVD, SUITE 202, TAMPA, FL 33606-2494
(406) 848-4391
(509) 323-1607
Mailing address
1000 W KENNEDY BLVD STE 202, TAMPA, FL 33606-1940
(406) 848-4391
(509) 323-1607
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
ME134199
FL
Other
Enumeration date
08/17/2018
Last updated
11/27/2018
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