Myrtle Ridge Family Medicine, PA

NPI #1427195809 in Lutz, Florida

Provider Information

NPI Number
1427195809
Entity Type
Organization
Organization Name
Myrtle Ridge Family Medicine, PA
Primary Specialty
Family Medicine
Enumeration Date
Feb 1, 2007
Last Updated
Jan 10, 2013

Practice Location

Address
1539 DALE MABRY HWY
Address 2
102
City
Lutz
State
Florida
ZIP Code
33548-3008
Phone
(813) 909-7102

Authorized Official

Name
JACK BERGH, MD
Title
CEO
Phone
(813) 909-7102

Specialties & Taxonomy Codes

Specialty
Family Medicine

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