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1124652425
VIVANT MEDICAL GROUP LLC
TAMPA, FL
NPI
1124652425
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Entity Type
Organization
Authorized Contact
DAPHNEE MOISE-JOHNSON
President
800-574-9491
Organization Subpart ?
No
Primary Taxonomy
208D00000X General Practice
Enumeration Date
2020-02-25
Last Update Date
2021-07-06
Business Address
VIVANT MEDICAL GROUP LLC
6214 MEMORIAL HWY STE B
TAMPA, FL 33615-4507
Phone number: 800-574-9491
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Mailing Address
VIVANT MEDICAL GROUP LLC
6214 MEMORIAL HWY STE B
TAMPA, FL 33615-4507
Phone number: 800-574-9491
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