ISSA F BAROUDI MD PA
Medical Practice at Tamiami Trl, Port Charlotte, FL

License number
Florida ME38318
Category
Medical Practice
Type
Plastic Surgery
Owner
Name: DR. ISSA F BAROUDI MD
Title: PRESIDENT
Phone: (941) 627-5155
Address
Address
3222 Tamiami Trl, Port Charlotte, FL 33952
National Provider ID: 1336426295
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ISSA F. BAROUDI, M.D., PA

3222 Tamiami Trl, Port Charlotte, FL 33952

Registration:
Jul 29, 1982
State ID:
F92498
Business type:
Florida Profit Corporation
President:
Issa F Baroudi (President), 3222 Tamiami Trl, Port Charlotte, FL 33952 (Physical)
Agent:
Hackett, Jack O, Ii,Farr Law Firm, Punta Gorda, FL 33950 (Physical)
EIN:
59-2206084

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