Healthcare Provider Details

I. General information

NPI: 1922023076
Provider Name (Legal Business Name): MEDICAL SPECIALIST ASSOCIATES OF FLORIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1064 KEENE RD
DUNEDIN FL
34698-6300
US

IV. Provider business mailing address

PO BOX 277781
ATLANTA GA
30384-7781
US

V. Phone/Fax

Practice location:
  • Phone: 727-733-9202
  • Fax:
Mailing address:
  • Phone: 813-852-3272
  • Fax: 813-852-3233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: CARL TREMONTI
Title or Position: CFO
Credential:
Phone: 727-843-4599