PANTIP INTACHAI

JACKSONVILLE, FL
NPI1497215123
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: FL  ME153109)
Enumeration Date2019-03-20
Last Update Date2022-08-05
Business Address
PANTIP INTACHAI
8203 BOATWRIGHT WAY
JACKSONVILLE, FL 32216-6309
Phone number: 661-264-6173
Mailing Address
PANTIP INTACHAI
2001 KINGSLEY AVE
ORANGE PARK, FL 32073-5148
Phone number: 661-264-6173
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