Graduated: 2024
NPI: 1265280143
Practice Locations (2)
OBSERVATION MEDICAL GROUP LLC
6901 SIMMONS LOOP
RIVERVIEW, FL 335789498
8133028000
OBSERVATION MEDICAL GROUP LLC
3001 W DR MARTIN LUTHER KING JR BLVD
TAMPA, FL 336076307
8138704000
Source: CMS National Downloadable File, September 2026.