Provider Demographics
NPI:1235541889
Name:MURALLON, ADOLFO JR (PT)
Entity Type:Individual
Prefix:
First Name:ADOLFO
Middle Name:
Last Name:MURALLON
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 PALMWAY LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-8518
Mailing Address - Country:US
Mailing Address - Phone:407-384-8450
Mailing Address - Fax:
Practice Address - Street 1:314 PALMWAY LN
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-8518
Practice Address - Country:US
Practice Address - Phone:407-384-8450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT5433174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist