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Individual

ROMEO ADANO TAGALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3885 S FLORIDA AVE, LAKELAND, FL 33813-1109
(863) 644-6608
(863) 644-0147
Mailing address
3885 S FLORIDA AVE, LAKELAND, FL 33813-1109
(863) 644-6608
(863) 644-0147

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME33472
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
066847800
FL
01
53592
BC FL
FL
01
P00870043
RAILROAD MC
Enumeration date
10/25/2005
Last updated
03/06/2014
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