Provider Demographics
NPI:1225065543
Name:TALIT, UZI (MD)
Entity Type:Individual
Prefix:
First Name:UZI
Middle Name:
Last Name:TALIT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3647 INNOVATION DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33812-4106
Mailing Address - Country:US
Mailing Address - Phone:863-646-5000
Mailing Address - Fax:863-646-5001
Practice Address - Street 1:3647 INNOVATION DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33812-4106
Practice Address - Country:US
Practice Address - Phone:863-646-5000
Practice Address - Fax:863-646-5001
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0056383207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062994400Medicaid
FL062994400Medicaid
E15658Medicare UPIN