Organization
SANTURCE MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ORLANDO E MIELES MD (MD/CEO)
(813) 651-0005
Entity
Organization
Contact information
Practice address
500 VONDERBURG DR STE 305, BRANDON, FL 33511-5976
(813) 651-0005
(813) 902-7234
Mailing address
500 VONDERBURG DR, SUITE 305, BRANDON, FL 33511-5964
(813) 624-9399
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700149143
—
FL
Enumeration date
08/16/2016
Last updated
07/21/2022
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