Individual
OSVANNY NODAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2123 WEST MARTIN LUTHER KING JR BLVD, SUITE 101, TAMPA, FL 33607
(813) 488-4801
(813) 405-4506
Mailing address
2123 W DR MARTIN LUTHER KING JR BLVD STE 101, TAMPA, FL 33607-6545
(813) 235-5068
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
18,942
PR
208D00000X
General Practice Physician
Primary
ACN693
FL
Other
Enumeration date
12/03/2014
Last updated
10/24/2018
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