VICENTE C FLORIDA MD PA
Osteopathic Medicine at Garden St, Titusville, FL

License number
Florida ME0071351
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: DR. VICENTE C FLORIDA III MD
Title: PRESIDENT/OWNER
Phone: (321) 267-4700
Address
Address
1309 Garden St, Titusville, FL 32796
National Provider ID: 1154519791
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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VICENTE C. FLORIDA, M.D., PA

Titusville, FL

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
May 26, 1998
Inactive since:
Sep 25, 2009
Addresses:
2500 Gdn St, Titusville, FL 32796 (Physical)
Titusville, FL 32781 (Mailing)
PO Box 339, Titusville, FL 32781
State ID:
P98000047846
Business type:
Florida Profit Corporation
Director:
Vicente Cm.d. Florida Director, inactive, 2599 Gdn St, Titusville, FL 32796 (Physical)
Agent:
Kevin Downey,2631 NW 41 St, Gainesville, FL 32606 (Physical)
EIN:
593511913

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