Most Relevant Information
Provider Data
| NPI Number: | 1003807868 |
| Provider Name: | JOSEPHINE RACIMO ESTAMPADOR TAN M.D |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | ME 60270 |
Most Important Dates
| Enumeration Date: | 11/02/2005 |
| Last Updated: | 11/26/2012 |
Provider Practice Location
1125 N CENTRAL AVE
KISSIMMEE
FL
347414405
Practice Location Phone/Fax
| Phone: | 4079311887 |
| Fax: | 4079312056 |
Provider Mailing Location
1125 N CENTRAL AVE
KISSIMMEE
FL
347414405
Provider Mailing Phone/Fax
| Phone: | 4079311887 |
| Fax: | 4079312056 |