TAGRID ADILI MD PA
Medical Practice at Prima Vista Blvd, Fort Pierce, FL

License number
Florida ME0067274
Category
Medical Practice
Type
Specialist
Owner
Name: TAGRID ADILI M.D.
Title: OWNER
Phone: (772) 807-7166
Address
Address
463 NW Prima Vista Blvd, Fort Pierce, FL 34983
National Provider ID: 1306068606
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about TAGRID ADILI MD PA at bizstanding.com

TAGRID ADILI, M.D., PA

463 NW Prima Vis Blvd, Port Saint Lucie, FL 34983

Status:
Inactive
Industry:
Psychiatrist, Neurologist
Inactive reason:
CANCEL ADM DISS/REV
Registration:
Sep 4, 1998
Inactive since:
Oct 31, 2003
State ID:
P98000077917
Business type:
Florida Profit Corporation
Director:
Tagrid M.d. Adili (Director), 463 Prima Vis Blvd, Port Saint Lucie, FL 34983 (Physical)
Agent:
Tagrid Adili,463 NW Prima Vis Blvd, Port Saint Lucie, FL 34983 (Physical)
EIN:
65-0865158

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