DAVID IKUDAYISI, MD, PA
Osteopathic Medicine at Waters Ave, Tampa, FL

License number
Florida ME 87841
Category
Osteopathic Medicine
Type
Internal Medicine
License number
Florida ME 87841
Category
Osteopathic Medicine
Type
Geriatric Medicine
Owner
Name: MR. DAVID OMOTAYO IKUDAYISI MD
Title: PRESIDENT/OWNER
Phone: (813) 932-9798
Address
Address
3651B W Waters Ave, Tampa, FL 33614
National Provider ID: 1801892963
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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David Ikudayisi M.D., PA

Tampa, FL

Industry:
Diet Center Operation, Internist
Doing business as:
David Ikudayisi MD PA<br>Glory Medical Center & Weight<br>David Ikudayisi MD,PA
Registration:
Feb 4, 2004
Phone:
(813) 932-9798 (Phone)
Addresses:
3651 W Waters Ave, Tampa, FL 33614
PO Box 272450, Tampa, FL 33688
3651B W Waters Ave, Tampa, FL 33614
State ID:
P04000024717
Business type:
Domestic for Profit Corporation
Medical Doctors:
David Omotayo Ikudayisi (President, Secretary, Owner, Physician Assistant),Sandra Jones Manager, inactive,Leo A. Perez Medical Doctor, inactive
Agent:
Gary Walker

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