Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Vivant Medical Group LLC

Organization General Practice Physician · NPI 1124652425

Vivant Medical Group LLC is a General Practice Physician in Tampa, Florida. Works from 2 locations. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6214 Memorial Hwy Ste B
Tampa, FL 33615-4507
Phone: (800) 574-9491
Fax: (800) 547-2802
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 15600 Hancock Rd, Sarasota, FL 34240-6701 — (813) 924-5210

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X

Record details

NPI number1124652425
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Daphnee Moise-Johnson — President · (800) 574-9491
NPI enumeratedFebruary 25, 2020
Last updated in NPPESJuly 6, 2021
Certification dateJuly 6, 2021
Mailing address6214 Memorial Hwy Ste B, Tampa, FL 33615-4507

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