# ROMEO A TAGALA MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477866804
- **Authorized official:** ROMEO A TAGALA M.D. (OWNER/PHYSICIAN)
- **Authorized official phone:** (863) 644-6608

## Contact information

- **Practice address:** 3885 S FLORIDA AVE, LAKELAND, FL 33813-1109
- **Practice address phone:** (863) 644-6608
- **Practice address fax:** (863) 644-0147
- **Mailing address:** 3885 S FLORIDA AVE, LAKELAND, FL 33813-1109
- **Mailing address phone:** (863) 644-6608
- **Mailing address fax:** (863) 644-0147

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ME33472 | FL | Yes |

## Other

- **Enumeration date:** 07/14/2010
- **Last updated:** 03/06/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 066847800 | — | FL |
| 01 | — | 53592 | BC FL | FL |
| 01 | — | DQ7519 | RAILROAD MC | — |