| NPI | 1891556049 |
|---|---|
| Other Name | LIVEACTIVE MULTISPECIALTY PHYSICIAN GROUP TAMPA |
| Entity Type | Organization |
| Authorized Contact | SHANE BRETHOWR CEO/Authorized Official 913-549-3884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208M00000X Hospitalist |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2024-01-16 |
| Last Update Date | 2024-09-14 |