| NPI | 1619504354 |
|---|---|
| Doing Business As | MYRTLE RIDGE PRIMARY CARE, P.A |
| Entity Type | Organization |
| Authorized Contact | YUDAISY MOGENA PADRON Office Manager 813-909-7102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2024-05-06 |