Tommy L Louisville MD PA
NPI #1093123838 in Winter Haven, Florida
Provider Information
- NPI Number
- 1093123838
- Entity Type
- Organization
- Organization Name
- Tommy L Louisville MD PA
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MEDVANTX, INC.
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- Jul 24, 2014
- Last Updated
- Jul 24, 2014
Practice Location
- Address
- 320 1ST ST S
- City
- Winter Haven
- State
- Florida
- ZIP Code
- 33880-3501
- Phone
- (863) 299-8485
Authorized Official
- Name
- KENNY HEINE
- Title
- VP OF OPERATIONS
- Phone
- (858) 964-1506
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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