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1563 Land O Lakes Blvd Lutz FL 33549-2930 | |
| (813) 949-4224 | |
| (813) 949-2809 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 1563 Land O Lakes Blvd, Lutz, Florida |
| Authorized Official Name and Position | Kevin Meriwether (PRESIDENT) |
| Authorized Official Contact | 3055002000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6101 Blue Lagoon Dr Ste 200 Miami FL 33126-3168 Ph: (305) 500-2000 | 1563 Land O Lakes Blvd Lutz FL 33549-2930 Ph: (813) 949-4224 |
| NPI Number | 1164096764 |
|---|---|
| Provider Enumeration Date | 05/18/2021 |
| Last Update Date | 11/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164096764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
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