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Individual

RUVESPIERE CADUNGOG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3884 HAMPTON HILLS DR, LAKELAND, FL 33810-3839
(504) 729-7619
Mailing address
3884 HAMPTON HILLS DR, LAKELAND, FL 33810-3839
(504) 729-7619

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
L12000052558
FL

Other

Enumeration date
04/01/2015
Last updated
04/01/2015
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