Organization
THE FAMILY PHYSICIAN OF BVL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAUSTO RONALD BURGOS MD (PHYSICAN)
(407) 348-9111
Entity
Organization
Contact information
Practice address
3071 MICHIGAN AVE, KISSIMMEE, FL 34744-1501
(407) 348-9111
(407) 348-9112
Mailing address
3071 MICHIGAN AVE, KISSIMMEE, FL 34744-1501
(407) 348-9111
(407) 348-9112
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
ME62672
FL
Other
Enumeration date
05/17/2007
Last updated
04/27/2011
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