Organization
ANGEL MEDICAL CLINIC, LLC
Active
Other names
Kenadday Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID OMOTAYO IKUDAYISI M.D. (OWNER/PRES)
(813) 304-2330
Entity
Organization
Contact information
Practice address
8001 N DALE MABRY HWY STE 701, TAMPA, FL 33614-3218
(813) 304-2330
(813) 304-2346
Mailing address
8019 N HIMES AVE STE 200, TAMPA, FL 33614-2760
(813) 932-9798
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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