Organization
ALL MEDICAL GROUP OF TAMPA BAY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
S S M.D (O)
(813) 765-1930
Entity
Organization
Contact information
Practice address
3413 S KINGS AVE, BRANDON, FL 33511-7780
(888) 888-8888
Mailing address
3413 S KINGS AVE, BRANDON, FL 33511-7780
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IA903Z
—
FL
Enumeration date
09/24/2015
Last updated
01/26/2016
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