Individual
DR. ANTHONY NOSA IMUDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2324 CYPRESS CV, WESLEY CHAPEL, FL 33544-6787
(813) 321-0146
Mailing address
PO BOX 25317, TAMPA, FL 33622-5317
(813) 286-0033
(813) 282-1806
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
ME115842
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009039400
—
FL
01
—
14R2J
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/17/2007
Last updated
06/04/2020
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