LEGACY HEALTH MEDICAL GROUP, LLC

LARGO, FL
NPI1881942779
Entity TypeOrganization
Authorized ContactSUNIT SRIVASTAVA
Managing Member
727-644-1540
Organization Subpart ?No
Primary Taxonomy261QM1300X Clinic/Center Multi-Specialty
Additional Taxonomies207R00000X Internal Medicine
(Licence: FL  ME105069)
Enumeration Date2012-08-27
Last Update Date2019-07-25
Business Address
LEGACY HEALTH MEDICAL GROUP, LLC
3500 OAK MANOR LN # 46
LARGO, FL 33774-1211
Phone number: 727-489-3305
Mailing Address
LEGACY HEALTH MEDICAL GROUP, LLC
3500 OAK MANOR LN # 46
LARGO, FL 33774-1211
Phone number: 727-489-3305