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Individual

DR. DAVID P DIVITA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1120 10TH ST E, PALMETTO, FL 34221-4134
(941) 847-7903
(941) 847-7919
Mailing address
5130 SUNFOREST DR STE 300, TAMPA, FL 33634-6327
(727) 824-0780

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME86246
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080194322
RAIL ROAD MEDICARE
FL
05
267953100
FL
01
57812
BCBS
FL
Enumeration date
09/14/2005
Last updated
09/06/2022
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