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Organization
R MICHAEL TUCKER MD PA
Active
Organization
R MICHAEL TUCKER MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RALPH MICHAEL TUCKER MD (OWNER)
(239) 481-7000
Entity
Organization
Contact information
Practice address
60 WESTMINSTER ST N, SUITE A, LEHIGH ACRES, FL 33936-6518
(239) 368-1808
(239) 481-8150
Mailing address
8851 BOARDROOM CIR, FORT MYERS, FL 33919-4888
(239) 481-7000
(239) 433-8999
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME51024
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME51024
MEDICAL LICENSE
FL
Enumeration date
10/09/2013
Last updated
10/09/2013
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