Organization
SYCAMORE MED INC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA PATEL MD (OWNER)
(917) 855-4500
Entity
Organization
Contact information
Practice address
320 W FLETCHER AVE STE 102, TAMPA, FL 33612-3400
(813) 679-5276
(813) 354-3638
Mailing address
17010 VILESTA DR, LUTZ, FL 33548-7209
(917) 855-4500
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME111281
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03064197
—
FL
Enumeration date
09/15/2017
Last updated
06/16/2018
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