Burnt Store Family Medicine P L
Burnt Store Family Medicine P L is a Family Medicine Physician in Punta Gorda, Florida. Licensed in Florida. Registered with an NPI since 2010.
- Licensed in
- FL
- In the registry since
- 2010
Practice location Address checks out
100 Madrid Blvd Ste 513Punta Gorda, FL 33950-7968
Phone: (941) 505-0974
Fax: (941) 505-8517
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Family Medicine Physician (primary) | Taxonomy 207Q00000X · Licence ME0072508 (FL) |
|---|
Record details
| NPI number | 1164739421 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Gordon Wang — Owner · (941) 505-0974 |
| NPI enumerated | September 8, 2010 |
| Last updated in NPPES | June 23, 2011 |
| Mailing address | 100 Madrid Blvd, Suite 513, Punta Gorda, FL 33950-7968 |
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