Organization
DAVITA MEDICAL GROUP FLORIDA CIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN EDGINGTON (CFO)
(727) 824-0780
Entity
Organization
Contact information
Practice address
2304 ALOMA AVE, WINTER PARK, FL 32792-3330
(407) 679-9222
Mailing address
10051 5TH ST N STE 200, ST PETERSBURG, FL 33702-2211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/20/2017
Last updated
09/20/2017
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