| Glory Center, P.a. | |
|
6641 Madison St Suite 3 New Port Richey FL 34652-1966 | |
| (727) 232-0826 | |
| (727) 597-8487 |
| Full Name | Glory Center, P.a. |
|---|---|
| Speciality | Clinic/center |
| Location | 6641 Madison St, New Port Richey, Florida |
| Authorized Official Name and Position | David O Ikudayisi (OWNER/PRESIDENT) |
| Authorized Official Contact | 8134952234 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Glory Center, P.a. 6641 Madison St Suite 3 New Port Richey FL 34652-1966 Ph: (727) 232-0826 | Glory Center, P.a. 6641 Madison St Suite 3 New Port Richey FL 34652-1966 Ph: (727) 232-0826 |
| NPI Number | 1558617399 |
|---|---|
| Provider Enumeration Date | 07/31/2012 |
| Last Update Date | 02/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558617399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Florida) | Primary |
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