Organization
MYDOCTOREB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHIA EDWARDS-BENNETT MD (OWNER)
(646) 408-7092
Entity
Organization
Contact information
Practice address
17407 LOTINO PL, LUTZ, FL 33548-4815
(646) 408-7092
Mailing address
17407 LOTINO PL, LUTZ, FL 33548-4815
(646) 408-7092
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
—
—
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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