VIVIFY PLASTIC SURGERY LLC NPI 1073093175

NPI Information

VIVIFY PLASTIC SURGERY LLC is a plastic and reconstructive surgery surgery in Tampa, FL. The provider is a surgeon who specializes in plastic and reconstructive surgery. VIVIFY PLASTIC SURGERY LLC NPI is 1073093175. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1000 W KENNEDY BLVD
SUITE 202
TAMPA, FL
ZIP 33606-494
Phone: (406) 848-4391
Fax: (509) 323-1607

The provider's authorized official is Dallas R. Buchanan .
The authorized official title is Owner/provider and has the following contact phone number (833) 284-8439.

The enumeration date for this NPI number is 8/17/2018 and was last updated on 11/27/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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