Graduated: 2002
NPI: 1679985956
Practice Locations (2)
LA VIDA MEDICAL GROUP INC
120 STATE ST E, SUITE 101
OLDSMAR, FL 346773647
8132966266
OPTUMCARE FLORIDA, LLC
3675 W WATERS AVE, OPTUM FOUNTAIN OAKS
TAMPA, FL 336142783
8139152000
Source: CMS National Downloadable File, September 2026.