RALPH M WURSTER, D.O P.A
Osteopathic Medicine at Celebration Blvd, Kissimmee, FL

License number
Florida OS6853
Category
Osteopathic Medicine
Type
General Practice
Owner
Name: LAURA WURSTER R.N
Title: ADMINISTRATOR
Phone: (407) 749-3336
Address
Address
1530 Celebration Blvd SUITE 402, Kissimmee, FL 34747
National Provider ID: 1881981173
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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RALPH M. WURSTER, D.O, PA

Kissimmee, FL

Status:
Inactive
Inactive reason:
REINSTATEMENT
Registration:
Mar 29, 2010
Inactive since:
Oct 13, 2014
Addresses:
2940 Mallory Cir SUITE 201, Kissimmee, FL 34747 (Physical)
1530 Celebration Blvd, Kissimmee, FL 34747
1910 Windward Oaks Ct, Kissimmee, FL 34746
State ID:
P10000027748
Business type:
Florida Profit Corporation
Presidents:
John S Adams, 2940 Mallory Cir SUITE 201, Kissimmee, FL 34747 (Physical),Keith Huzyak, 2940 Mallory Cir SUITE 201, Kissimmee, FL 34747 (Physical),Ralph M Wurster President, inactive, 1530 Celebration Blvd SUITE 402, Kissimmee, FL 34747 (Physical)
Agent:
John Adams,2940 Mallory Cir, Kissimmee, FL 34747 (Physical)
EIN:
272330710

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