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Organization

JAMES M LIGHT MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES M LIGHT MD (PRESIDENT)
(727) 522-4485
Entity
Organization

Contact information

Practice address
2299 9TH AVE N, SUITE1 A, ST PETERSBURG, FL 33713-6800
(727) 989-4458
(727) 321-7918
Mailing address
940 42ND AVE N, ST PETERSBURG, FL 33703-4532
(727) 522-4485
(727) 520-9033

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ME0025779
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
058195000
FL
Enumeration date
12/10/2008
Last updated
12/10/2008
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