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Organization

KOYO MEDICAL P A

Active
Other names
KOYO MEDICAL P A
Organization subpart
No

Provider details

NPI number
Authorized official
EDET ATING ELENSI MD (PRESIDENT)
(813) 468-1899
Entity
Organization

Contact information

Practice address
19909 TAMIAMI AVE, TAMPA, FL 33647-3366
(813) 468-1899
(813) 428-5657
Mailing address
19909 TAMIAMI AVE, TAMPA, FL 33647-3366

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME90895
FL

Other

Enumeration date
08/27/2012
Last updated
10/19/2012
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