Organization
GLORY CENTER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID O IKUDAYISI M.D. (OWNER/PRESIDENT)
(813) 495-2234
Entity
Organization
Contact information
Practice address
6641 MADISON ST, SUITE 3, NEW PORT RICHEY, FL 34652-1966
(727) 232-0826
(727) 597-8487
Mailing address
6641 MADISON ST, SUITE 3, NEW PORT RICHEY, FL 34652-1966
(727) 232-0826
(727) 597-8487
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
FL
Other
Enumeration date
07/31/2012
Last updated
02/05/2013
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