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General NPI Number Information
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NPI Number | 1093032278
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Entity Type | Organization
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Legal Business Name | HELGEMO & LIOU PEDIATRICS
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Dates
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Enumeration Date | 04/27/2010
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Last Update Date | 04/27/2010
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Provider Practice Location Address
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Address Line | 2040C TAMIAMI TRL
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-2178
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Country | US
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Telephone | 941-629-4464
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Fax | 941-629-4701
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Provider Business Mailing Address
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Address Line | 2040C TAMIAMI TRL
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-2178
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Country | US
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Telephone | 941-629-4464
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Fax | 941-629-4701
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Authorized Official
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Title or Position | PARTNER
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Name | DEWITT BENJAMIN HELGEMO
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Credential | MD
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Telephone | 941-629-4464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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