Healthcare Provider Details

I. General information

NPI: 1609890045
Provider Name (Legal Business Name): JUNIAS DESAMOUR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 MAPLE STREET SUITE 1102
ALTAMONTE SPRINGS FL
32714
US

IV. Provider business mailing address

370 MAPLE STREET SUITE 1102
ALTAMONTE SPRINGS FL
32714
US

V. Phone/Fax

Practice location:
  • Phone: 407-705-3636
  • Fax: 407-809-5222
Mailing address:
  • Phone: 407-705-3636
  • Fax: 407-809-5222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME 86952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: