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Organization

GABRIEL A DECANDIDO PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MELISSA A MCLAIN (BILLING MANAGER)
(727) 536-0441
Entity
Organization

Contact information

Practice address
8005 ULMERTON RD, LARGO, FL 33771-3971
(727) 536-0441
(727) 535-1985
Mailing address
PO BOX 2056, LARGO, FL 33779-2056
(727) 536-0441
(727) 535-1985

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME39740
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
068744800
FL
Enumeration date
11/06/2007
Last updated
01/22/2008
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