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Organization
VICTORINA'S DIABETES ENDOCRINOLOGY AND METABOLISM, INC
Active
Organization
VICTORINA'S DIABETES ENDOCRINOLOGY AND METABOLISM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILFRED MARCO VICTORINA M.D. (PRESIDENT)
(859) 496-1803
Entity
Organization
Contact information
Practice address
4879 PALM COAST PKWY NW, UNIT # 2, PALM COAST, FL 32137-3672
(386) 225-4462
Mailing address
PO BOX 350812, PALM COAST, FL 32135-0812
(386) 225-4462
(386) 225-4465
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
ME126126
FL
Other
Enumeration date
09/04/2016
Last updated
04/06/2017
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