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General NPI Number Information
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NPI Number | 1457640252
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Entity Type | Organization
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Legal Business Name | EUGENE ANTON TRUCHELUT
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Dates
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Enumeration Date | 04/01/2011
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Last Update Date | 11/14/2011
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Provider Practice Location Address
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Address Line | 727 VASSAR ST
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City | ORLANDO
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State | FL
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Zip | 32804-4920
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Country | US
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Telephone | 407-849-0330
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Fax | 407-849-0351
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Provider Business Mailing Address
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Address Line | 727 VASSAR ST
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City | ORLANDO
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State | FL
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Zip | 32804-4920
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Country | US
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Telephone | 407-849-0330
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Fax | 407-849-0351
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Authorized Official
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Title or Position | OWNER
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Name | DR. EUGENE ANTON TRUCHELUT
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Credential | MD
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Telephone | 407-849-0330
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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 |
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License Number State |
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