Organization Name: | RALPH M WURSTER, D.O P.A |
NPI Number: | 1881981173 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAURA WURSTER (ADMINISTRATOR) |
Mailing Address: | 1530 Celebration Blvd Suite 402 Celebration |
State: | FL US |
Postal Code: | 347475164 |
Phone Number: | 4075664763 |
Fax Number: | |
NPI Enumeration Date: | 07/07/2011 |
NPI Last Update Date: | 07/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OS6853 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |