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Individual

MR. RALPH SURACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
108 ALEUTIAN ST NE, LAKE PLACID, FL 33852-3418
(863) 441-7295
Mailing address
108 ALEUTIAN ST NE, LAKE PLACID, FL 33852-3418
(863) 441-7295

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
S620737752410
FL

Other

Enumeration date
05/13/2010
Last updated
05/13/2010
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