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Specialty details in registry · Monticello, FL

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At a glance

960 Rocky Branch Rd, Monticello, FL 32344-2706

NPPES record updated Jan 24, 2017. Public records can lag behind changes at a practice.

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Insurance participation and appointment availability are not established by these public records.

Practice location

960 Rocky Branch Rd
Monticello, FL 32344-2706
Professional details: NPI, taxonomy & registry record
NPI1245777671
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Registry details

Primary taxonomy
Specialty details in registry
Taxonomy code
164W00000X
Enumeration date
Jan 24, 2017
Record updated
Jan 24, 2017
More registry details
Provider type
Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

164W00000X · Primary

License reported: PN5226936 FL

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

960 Rocky Branch Rd
Monticello, FL 32344-2706
Phone
(850) 342-0906
Mailing address
960 ROCKY BRANCH RD

MONTICELLO, FL 323442706
Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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