Estampador Tan, Josephine Racimo

Estampador Tan, Josephine Racimo is an sole proprietor health care provider with primary practice located at 1125 N Central Ave , Kissimmee FL 34741-4405. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Estampador Tan, Josephine Racimo can be contacted via phone (407) 931-1887.

Contact Information

Primary practice address
1125 N Central Ave Kissimmee FL 34741-4405
Phone: (407) 931-1887
Fax: (407) 931-2056
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME 60270 Florida

Profile Details

NPI number 1003807868
LBN Legal business name Estampador Tan, Josephine Racimo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2005
Last updated Nov 26th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003807868 NPPES
Florida Other 1290808 CIGNA PROVIDER ID #
Florida Other 270637 CIGNA PROVIDER ID #
Florida Other 14049 CIGNA PROVIDER ID #
Florida Other 173108 CIGNA PROVIDER ID #
Florida MEDICAID 371692900 CIGNA PROVIDER ID #

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