Organization
GREGORIO MEDALLE PA
Active
Other names
GREGORIO N. MEDALLE, M.D., P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORIO N MEDALLE M.D. (OWNER/PHYSICIAN)
(863) 773-3773
Entity
Organization
Contact information
Practice address
1052 DOWNING CIR, WAUCHULA, FL 33873-3358
(863) 773-3773
(863) 773-0358
Mailing address
1052 DOWNING CIR, WAUCHULA, FL 33873-3358
(863) 773-3773
(863) 773-0358
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME0044016
FL
208D00000X
General Practice Physician
ME0044016
FL
Other
Enumeration date
07/29/2010
Last updated
08/16/2010
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