Individual
JIM BRONSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
32815 RADIO RD, LEESBURG, FL 34788-3902
(352) 787-8531
(352) 787-3041
Mailing address
312 W DELAWARE ST, TAVARES, FL 32778-2144
(352) 255-9546
(352) 787-3041
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA24597
FL
Other
Enumeration date
09/27/2007
Last updated
09/27/2007
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