Doctor Name: | ROMEO ADANO TAGALA |
NPI Number: | 1992795587 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME33472 |
Business Practice Address: | 3885 S Florida Ave Lakeland, FL - 338131109 |
Business Phone Number: | 8636446608 |
Business Fax Number: | 8636440147 |
Mailing Address: | 3885 S Florida Ave, LAKELAND |
State: | FL |
Postal Code: | 338131109 |
Phone Number: | 8636446608 |
Fax Number: | 8636440147 |
NPI Enumeration Date: | 10/25/2005 |
NPI Last Update Date: | 03/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME33472 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |