Gregorio Medalle PA

NPI #1194039321 in Wauchula, Florida

Provider Information

NPI Number: 1194039321
Entity Type: Organization
Organization Name: Gregorio Medalle PA
Primary Specialty: Surgery
Enumeration Date: Jul 29, 2010
Last Updated: Aug 16, 2010

Practice Location

Address: 1052 DOWNING CIR
City: Wauchula
State: Florida
ZIP Code: 33873-3358
Phone: (863) 773-3773

Authorized Official

Name: GREGORIO N MEDALLE, M.D.
Title: OWNER/PHYSICIAN
Phone: (863) 773-3773

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X
Surgery	208600000X	Primary

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