Healthcare Provider Details

I. General information

NPI: 1205289600
Provider Name (Legal Business Name): EFIGEN MEDICAL. INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2016
Last Update Date: 07/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7211 N DALE MABRY HWY STE 222
TAMPA FL
33614-2669
US

IV. Provider business mailing address

7211 N DALE MABRY HWY STE 222
TAMPA FL
33614-2669
US

V. Phone/Fax

Practice location:
  • Phone: 813-402-0798
  • Fax:
Mailing address:
  • Phone: 813-402-0798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. SANDRA E NADAL
Title or Position: OWNER
Credential:
Phone: 813-402-0798