Organization
TAMPA SUD MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARTER DAVIDSON POPE JR. (CEO)
(404) 333-2277
Entity
Organization
Contact information
Practice address
65 65TH ST S STE A, ST PETERSBURG, FL 33707-1338
(501) 765-4799
Mailing address
65 65TH ST S STE A, ST PETERSBURG, FL 33707-1338
(501) 765-4799
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/13/2022
Last updated
07/13/2022
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