| Gregorio Medalle Pa | |
|
1052 Downing Cir Wauchula FL 33873-3358 | |
| (863) 773-3773 | |
| (863) 773-0358 |
| Full Name | Gregorio Medalle Pa |
|---|---|
| Speciality | Surgery |
| Location | 1052 Downing Cir, Wauchula, Florida |
| Authorized Official Name and Position | Gregorio N Medalle (OWNER/PHYSICIAN) |
| Authorized Official Contact | 8637733773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregorio Medalle Pa 1052 Downing Cir Wauchula FL 33873-3358 Ph: (863) 773-3773 | Gregorio Medalle Pa 1052 Downing Cir Wauchula FL 33873-3358 Ph: (863) 773-3773 |
| NPI Number | 1194039321 |
|---|---|
| Provider Enumeration Date | 07/29/2010 |
| Last Update Date | 08/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194039321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | ME0044016 (Florida) | Secondary |
| 208600000X | Surgery | ME0044016 (Florida) | Primary |
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