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3655 Tampa Rd Oldsmar FL 34677-6307 | |
| (813) 854-7566 | |
| (813) 854-7005 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 3655 Tampa Rd, Oldsmar, Florida |
| Authorized Official Name and Position | Jon Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | 3655 Tampa Rd Oldsmar FL 34677-6307 Ph: (813) 854-7566 |
| NPI Number | 1457870065 |
|---|---|
| Provider Enumeration Date | 09/14/2017 |
| Last Update Date | 08/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457870065 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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