Organization
TAMARA PISTORIA D.O.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA PISTORIA D.O. (OWNER)
(863) 293-3909
Entity
Organization
Contact information
Practice address
400 AVENUE K SE, STE 5, WINTER HAVEN, FL 33880-4146
(863) 293-3909
Mailing address
400 AVENUE K SE, STE 5, WINTER HAVEN, FL 33880-4146
(863) 293-3909
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OF0008614
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
264246800
—
FL
Enumeration date
05/23/2007
Last updated
03/07/2023
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