| Advanced Endo Lakemont | |
|
4890 W Kennedy Blvd Ste 9204890w Tampa FL 33609-1851 | |
| (813) 692-2200 | |
| Not Available |
| Full Name | Advanced Endo Lakemont |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4890 W Kennedy Blvd Ste 9204890w, Tampa, Florida |
| Authorized Official Name and Position | Timothy Muscaro (OWNER) |
| Authorized Official Contact | 8136922200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Endo Lakemont 4890 W Kennedy Blvd Ste 920 Tampa FL 33609-1850 Ph: (813) 692-2200 | Advanced Endo Lakemont 4890 W Kennedy Blvd Ste 9204890w Tampa FL 33609-1851 Ph: (813) 692-2200 |
| NPI Number | 1497562979 |
|---|---|
| Provider Enumeration Date | 12/17/2024 |
| Last Update Date | 09/02/2025 |
| Certification Date | 08/29/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497562979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
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