OrganizationActive
Vivant Medical Group LLC
NPI 1124652425 · General Practice Physician · Tampa, FL
Provider details
- NPI number
- 1124652425
- Entity type
- Organization
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Daphnee Moise-Johnson, President(800) 574-9491
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
6214 Memorial Hwy Ste B
Tampa, FL 33615-4507
Phone: (800) 574-9491
Fax: (800) 547-2802
Street-level locationGet directions
Mailing address
6214 Memorial Hwy Ste B
Tampa, FL 33615-4507
Additional practice locations (1)
- 15600 Hancock RdSarasota, FL 34240-6701Phone: (813) 924-5210
Registry dates
- Enumerated
- 2020-02-25
- Last updated
- 2021-07-06
- Certified
- 2021-07-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.