Organization Name: | SOPHOS INVESTMENTS LLC |
NPI Number: | 1558404400 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BABALOLA OLUSOLA OLUWOLE (PRESIDENT) |
Mailing Address: | 8875 Hidden River Pkwy Suite 300 Tampa |
State: | FL US |
Postal Code: | 336371035 |
Phone Number: | 8133004035 |
Fax Number: | |
NPI Enumeration Date: | 02/14/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME 74212 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |