Organization
SEDONA ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLETTE BURLESON (PRACTICE MANAGER)
(352) 694-6331
Entity
Organization
Contact information
Practice address
841 S PONCE DE LEON BLVD STE 4, SAINT AUGUSTINE, FL 32084-6008
(904) 907-2228
Mailing address
6160 SW HIGHWAY 200 UNIT 119, OCALA, FL 34476-8307
(352) 694-6331
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
—
Other
Enumeration date
03/04/2021
Last updated
03/04/2021
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