Organization
BEIDEMARIAM MILTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEIDEMARIAM MILTON (OWNER)
(850) 385-0370
Entity
Organization
Contact information
Practice address
1022 MARYS DR, TALLAHASSEE, FL 32308-5266
(850) 385-0370
Mailing address
1022 MARYS DR, TALLAHASSEE, FL 32308-5266
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
9328911
FL
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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