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Organization
THE FAMILY DOCTORS OF BUENA VENTURA PA
Active
Organization
THE FAMILY DOCTORS OF BUENA VENTURA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIN BAUTISTA M.D (PRESIDENT)
(407) 348-0399
Entity
Organization
Contact information
Practice address
14050 TOWN LOOP BLVD, SUITE 201, ORLANDO, FL 32837-6190
(407) 348-0399
(407) 348-8350
Mailing address
14050 TOWN LOOP BLVD, SUITE 201, ORLANDO, FL 32837-6190
(407) 348-0399
(407) 348-8350
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME62124
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370827600
—
FL
Enumeration date
05/04/2007
Last updated
08/20/2014
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