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1073037297
EDMUND BONGOLAN
TAMPA, FL
NPI
1073037297
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: FL ARNP9310211)
Enumeration Date
2017-07-30
Last Update Date
2020-08-20
Business Address
EDMUND BONGOLAN ARNP
701 N WEST SHORE BLVD
TAMPA, FL 33609-1122
Phone number: 813-533-7080
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Mailing Address
EDMUND BONGOLAN ARNP
5204 HAMPTON BEACH PL
TAMPA, FL 33609-2498
Phone number: 813-732-1749
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