MYRTLE RIDGE FAMILY MEDICINE, PA

LUTZ, FL
NPI1427195809
Entity TypeOrganization
Authorized ContactJACK BERGH
CEO
813-909-7102
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: FL  ME0056971)
Enumeration Date2007-02-01
Last Update Date2013-01-10
Business Address
MYRTLE RIDGE FAMILY MEDICINE, PA
1539 DALE MABRY HWY 102
LUTZ, FL 33548-3008
Phone number: 813-909-7102
Mailing Address
MYRTLE RIDGE FAMILY MEDICINE, PA
PO BOX 660
LUTZ, FL 33548-0660
Phone number: 813-909-7102
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