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General NPI Number Information
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NPI Number | 1235336132
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE SERVICES OF POLK COUNTY INC
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 103 ESCAMBIA
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City | DAVENPORT
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State | FL
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Zip | 33837-4119
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Country | US
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Telephone | 863-421-7778
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Fax | 863-421-7795
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Provider Business Mailing Address
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Address Line | 103 ESCAMBIA
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City | DAVENPORT
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State | FL
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Zip | 33837-4119
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Country | US
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Telephone | 863-421-7778
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Fax | 863-421-7795
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CEFERINA B DEL ROSARIO
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Credential | MD
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Telephone | 863-421-7778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME74133
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License Number State | FL
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