Organization
FAMILY MEDICAL CARE OF PALM COAST LLC
Active
Other names
Vicencio Antonio III
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONIO SISON VICENCIO III MD (SOLE PROPRIETOR)
(386) 586-3466
Entity
Organization
Contact information
Practice address
21 HOSPITAL DR, SUITE 230, PALM COAST, FL 32164-2452
(386) 586-3466
(386) 586-3467
Mailing address
PO BOX 354339, PALM COAST, FL 32135-4339
(386) 586-3466
(386) 586-3467
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/10/2008
Last updated
09/10/2008
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