Healthcare Provider Details

I. General information

NPI: 1255669768
Provider Name (Legal Business Name): VI ENDOCRINOLOGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2009
Last Update Date: 03/31/2024
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5519 TERRAIN DE GOLF DR
LUTZ FL
33558-2862
US

IV. Provider business mailing address

5519 TERRAIN DE GOLF DR
LUTZ FL
33558-2862
US

V. Phone/Fax

Practice location:
  • Phone: 813-573-0064
  • Fax:
Mailing address:
  • Phone: 813-573-0064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number1491
License Number StateVI

VIII. Authorized Official

Name: JUDY ALLEN-RYAN BARZEY
Title or Position: PRESIDENT
Credential: MD
Phone: 813-573-0064