Organization
A PREMIER MEDICAL RESEARCH OF FLORIDA L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE TATAW BESONG M.D. (PRESIDENT & CEO)
(386) 747-9771
Entity
Organization
Contact information
Practice address
2728 ENTERPRISE RD STE 200, ORANGE CITY, FL 32763-8276
(386) 747-9771
Mailing address
2111 HONTOON RD, DELAND, FL 32720-4308
(386) 747-9771
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
ME074829
FL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
ME92729
FL
Other
Enumeration date
02/01/2017
Last updated
02/01/2017
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