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Individual

GEZA ACS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 972-4673
Mailing address
PO BOX 198441, ATLANTA, GA 30384-8441
(866) 761-5658

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
ME93386
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
273781700
FL
01
29865
BCBS
FL
Enumeration date
07/01/2006
Last updated
05/06/2015
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