Organization
ROMEO A TAGALA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROMEO A TAGALA M.D. (OWNER/PHYSICIAN)
(863) 644-6608
Entity
Organization
Contact information
Practice address
3885 S FLORIDA AVE, LAKELAND, FL 33813-1109
(863) 644-6608
(863) 644-0147
Mailing address
3885 S FLORIDA AVE, LAKELAND, FL 33813-1109
(863) 644-6608
(863) 644-0147
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME33472
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066847800
—
FL
01
—
53592
BC FL
FL
01
—
DQ7519
RAILROAD MC
—
Enumeration date
07/14/2010
Last updated
03/06/2014
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