Organization
BANUELOS FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIAS I BANUELOS M.D. (PRESIDENT)
(850) 490-6727
Entity
Organization
Contact information
Practice address
945 W MICHIGAN AVE STE 10C, PENSACOLA, FL 32505-2346
(850) 490-6727
Mailing address
945 W MICHIGAN AVE STE 10C, PENSACOLA, FL 32505-2346
(850) 490-6727
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME97139
FL
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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