Organization Name: | KINGDOM COME ENTERPRISES INC |
NPI Number: | 1952770752 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ISMAEL A BELOSO (OWNER) |
Mailing Address: | 2509 Oak Run Blvd Kissimmee |
State: | FL US |
Postal Code: | 347443019 |
Phone Number: | 3214437570 |
Fax Number: | 4076814603 |
NPI Enumeration Date: | 09/22/2015 |
NPI Last Update Date: | 09/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OS10148 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |