Banuelos Family Medicine, LLC

Organization Active NPI Family Medicine Physician · Milton, FL

NPI 1124366299 · NPPES record last updated Jan 24, 2013

Key facts

NPI
1124366299
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
ME97139 (FL)
Legal business name
BANUELOS FAMILY MEDICINE, LLC
Practice address
6061 Doctors Park
Milton, FL 32570-5073
Phone
(850) 983-8500
Fax
(850) 983-0009
NPI assigned
Jan 24, 2013
Organization subpart
No

Authorized official

Name
Dr. Elias Ignacio Banuelos, MD
Title
Ceo
Phone
(850) 983-8500

National Provider Directory

Locations

6061 Doctors Park
Milton, FL 32570
Phone (850) 602-7245

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207Q00000X ME97139 FL Yes

Addresses

Primary practice location

6061 Doctors Park
Milton, FL 32570-5073

Mailing address

6061 Doctors Park
Milton, FL 32570-5073
Phone (850) 983-8500

Other providers in Milton, FL

All providers in Milton, FL · Family Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.