| Invictus Equity Group, LLC | |
|
14801 Bruce B Downs Blvd Fl 33613 Tampa FL 33613-2844 | |
| (813) 971-4400 | |
| Not Available |
| Full Name | Invictus Equity Group, LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 14801 Bruce B Downs Blvd Fl 33613, Tampa, Florida |
| Authorized Official Name and Position | James K Emmons (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 7276560093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Invictus Equity Group, LLC 220 Newbury Pl N St Petersburg FL 33716-1305 Ph: (727) 656-0093 | Invictus Equity Group, LLC 14801 Bruce B Downs Blvd Fl 33613 Tampa FL 33613-2844 Ph: (813) 971-4400 |
| NPI Number | 1780420091 |
|---|---|
| Provider Enumeration Date | 07/05/2024 |
| Last Update Date | 02/11/2025 |
| Certification Date | 02/11/2025 |
| Medicare PECOS PAC ID | 5294247912 |
|---|---|
| Medicare Enrollment ID | O20250626001617 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780420091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Eduardo H Martinez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417955337 PECOS PAC ID: 5597867697 Enrollment ID: I20070220000567 |
| Provider Name | Neisa I Diaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033240510 PECOS PAC ID: 3779675012 Enrollment ID: I20070816000508 |
| Provider Name | Erik William Gottschling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063146082 PECOS PAC ID: 7012398225 Enrollment ID: I20220719004068 |
| Provider Name | Gina Pergolizzi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194513473 PECOS PAC ID: 5496256695 Enrollment ID: I20250828005306 |
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