Organization
MEDICAL STUDIO INC
Active
Other names
The Medical Studio
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GABOR MENCZELESZ MD (AUTHORIZED REPRESENTATIVE)
(904) 575-2285
Entity
Organization
Contact information
Practice address
1437 FLAGLER AVE, JACKSONVILLE, FL 32207-8516
(904) 575-2285
Mailing address
4312 PLAZA GATE LN S, APT 101, JACKSONVILLE, FL 32217-5411
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME122201
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME122201
LICENSE
FL
Enumeration date
09/28/2016
Last updated
09/28/2016
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