Organization
NODAL MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OSVANNY NODAL MD (MEDICAL DOCTOR)
(813) 488-4801
Entity
Organization
Contact information
Practice address
2123 W DR MARTIN LUTHER KING JR BLVD STE 101, TAMPA, FL 33607-6545
(813) 488-4801
(813) 405-4506
Mailing address
2123 W DR MARTIN LUTHER KING JR BLVD STE 101, TAMPA, FL 33607-6545
(813) 488-4801
(813) 405-4506
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ACN693
FL
Other
Enumeration date
06/12/2017
Last updated
06/20/2019
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