MEDICARE: AZAEL P. BORROMEO, M.D., P..

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	ME35326	FL

General Provider Information

NPI Number	:	1871741579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AZAEL P. BORROMEO, M.D., P..

Provider Business Mailing Address
First Line	:	2 WILLIAM TELL LN
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-3785
Country	:	US
Telephone Number	:	352-527-9555
Fax Number	:	352-527-2609

Provider Business Practice Location Address
First Line	:	2 WILLIAM TELL LN
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465-3785
Country	:	US
Telephone Number	:	352-527-9555
Fax Number	:	352-527-2609

Authorized Official
Title or Position	:	PHYSICIAN/PRESIDENT
Name	:	DR. AZAEL P BORROMEO
Credential	:	MD
Telephone Number	:	352-527-9555

Provider Enumeration Date	:	09/05/2008
Last Update Date	:	09/05/2008

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