Doctor Name: | MR. VICTOR MEDINA SERALDE |
NPI Number: | 1255449047 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME0041355 |
Business Practice Address: | 3750 Us Highway 27 N Ste 4f Sebring, FL - 338701658 |
Business Phone Number: | 8633824949 |
Business Fax Number: | 8633823811 |
Mailing Address: | 3750 Us Highway 27 N Ste 4f, SEBRING |
State: | FL |
Postal Code: | 338701658 |
Phone Number: | 8633824949 |
Fax Number: | 8633823811 |
NPI Enumeration Date: | 08/29/2006 |
NPI Last Update Date: | 01/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME0041355 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |