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Organization
LOURDES L VIRTUSIO M D FAMILY PRACTICE CLINIC INC
Active
Organization
LOURDES L VIRTUSIO M D FAMILY PRACTICE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOURDES L VIRTUSIO MD (OWNER)
(850) 432-4745
Entity
Organization
Contact information
Practice address
2102 TOWN STREET, PENSACOLA, FL 32526
(850) 432-4745
(850) 434-0395
Mailing address
2102 TOWN STREET, PENSACOLA, FL 32526
(850) 432-4745
(850) 434-0395
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251986100
—
FL
Enumeration date
05/07/2008
Last updated
11/29/2010
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