Organization
BREEZEFAST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TITI OGUNU NP (DIRECTOR)
(813) 867-4990
Entity
Organization
Contact information
Practice address
3902 HENDERSON BLVD STE 208-12, TAMPA, FL 33629-5038
(813) 867-4990
(813) 773-1176
Mailing address
3902 HENDERSON BLVD STE 208-12, TAMPA, FL 33629-5038
(813) 867-4990
(813) 773-1176
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
11/01/2021
Last updated
02/21/2022
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