Organization
CORNERSTONE MEDICAL CARE OF BRANDON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIO A ENRIQUEZ M.D. (MANAGING MEMBER)
(813) 681-5658
Entity
Organization
Contact information
Practice address
500 VONDERBURG DR, E TOWER STE 102, BRANDON, FL 33511-5964
(813) 681-5658
(813) 681-5250
Mailing address
500 VONDERBURG DR STE 102, BRANDON, FL 33511-5968
(813) 681-5658
(813) 681-5250
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
267292800
—
FL
Enumeration date
08/08/2006
Last updated
06/17/2021
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