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NPI Code Detail

MEDICARE: FLORIDA ORTHO ER LLC

MEDICARE: FLORIDA ORTHO ER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1659724441
Entity Type Code : Organization
Provider Name (Legal Business Name) : FLORIDA ORTHO ER LLC
Provider Business Mailing Address
First Line : 1536 PLANTATION POINTE DR
Second Line :
City : ORLANDO
State : FL
Zip : 32824-4840
Country : US
Telephone Number : 407-747-7236
Fax Number :
Provider Business Practice Location Address
First Line : 3607 ALOMA AVE STE 1081
Second Line :
City : OVIEDO
State : FL
Zip : 32765-8856
Country : US
Telephone Number : 407-747-7236
Fax Number :
Authorized Official
Title or Position : GENERAL MANAGER
Name : DR. JUAN CARLOS CARLOS MORENO
Credential :
Telephone Number : 407-747-7236
Provider Enumeration Date : 07/18/2016
Last Update Date : 07/18/2016

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Directions to “FLORIDA ORTHO ER LLC ” Practice Location

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