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General NPI Number Information
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NPI Number | 1912410895
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Entity Type | Organization
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Legal Business Name | DAVID W LYTER, MD MPH, PA
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Dates
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Enumeration Date | 11/14/2017
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Last Update Date | 07/15/2019
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Provider Practice Location Address
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Address Line | 4302 N HABANA AVE STE 200
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City | TAMPA
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State | FL
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Zip | 33607-6368
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Country | US
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Telephone | 813-518-0881
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Fax | 813-518-0882
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Provider Business Mailing Address
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Address Line | 4302 N HABANA AVE STE 200
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City | TAMPA
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State | FL
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Zip | 33607-6368
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Country | US
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Telephone | 813-518-0881
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Fax | 813-518-0882
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID W LYTER
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Credential | MD
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Telephone | 813-518-0881
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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 | ME79149
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License Number State | FL
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