Organization
WING SURGICAL PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH MELDRUM WING M.D. (PHYSICIAN)
(407) 322-7761
Entity
Organization
Contact information
Practice address
309 N MANGOUSTINE AVE, SANFORD, FL 32771-1098
(407) 322-7761
(407) 322-7763
Mailing address
309 N MANGOUSTINE AVE, SANFORD, FL 32771-1098
(407) 322-7761
(407) 322-7763
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
602761
FL
Other
Enumeration date
05/04/2010
Last updated
05/10/2010
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