Doctor Name: | DR. JOSEPHINE RACIMO ESTAMPADOR TAN |
NPI Number: | 1003807868 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D |
License Number: | ME 60270 |
Business Practice Address: | 1125 N Central Ave Kissimmee, FL - 347414405 |
Business Phone Number: | 4079311887 |
Business Fax Number: | 4079312056 |
Mailing Address: | 1125 N Central Ave, KISSIMMEE |
State: | FL |
Postal Code: | 347414405 |
Phone Number: | 4079311887 |
Fax Number: | 4079312056 |
NPI Enumeration Date: | 11/02/2005 |
NPI Last Update Date: | 11/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME 60270 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |