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General NPI Number Information
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NPI Number | 1780420091
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Entity Type | Organization
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Legal Business Name | INVICTUS EQUITY GROUP, LLC
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Dates
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Enumeration Date | 07/05/2024
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 14801 BRUCE B DOWNS BLVD FL 33613
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City | TAMPA
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State | FL
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Zip | 33613-2844
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Country | US
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Telephone | 813-971-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 220 NEWBURY PL N
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City | ST PETERSBURG
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State | FL
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Zip | 33716-1305
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Country | US
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Telephone | 727-656-0093
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. JAMES K EMMONS
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Credential |
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Telephone | 727-656-0093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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