| Mdiv | |
|
2150 49th St N Suite C Saint Petersburg FL 33710-5237 | |
| (727) 321-6130 | |
| (727) 327-2677 |
| Full Name | Mdiv |
|---|---|
| Speciality | Family Medicine |
| Location | 2150 49th St N, Saint Petersburg, Florida |
| Authorized Official Name and Position | William A La Torre (MANAGING PARTNER) |
| Authorized Official Contact | 7273216130 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mdiv 2150 49th St N Suite C Saint Petersburg FL 33710-5237 Ph: (727) 321-6130 | Mdiv 2150 49th St N Suite C Saint Petersburg FL 33710-5237 Ph: (727) 321-6130 |
| NPI Number | 1427458868 |
|---|---|
| Provider Enumeration Date | 09/03/2014 |
| Last Update Date | 09/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427458868 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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