Provider Demographics
NPI:1780420091
Name:INVICTUS EQUITY GROUP, LLC
Entity type:Organization
Organization Name:INVICTUS EQUITY GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:EMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-656-0093
Mailing Address - Street 1:220 NEWBURY PL N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1305
Mailing Address - Country:US
Mailing Address - Phone:727-656-0093
Mailing Address - Fax:
Practice Address - Street 1:14801 BRUCE B DOWNS BLVD FL 33613
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-2844
Practice Address - Country:US
Practice Address - Phone:813-971-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-05
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty