Healthcare Provider Details

I. General information

NPI: 1083022842
Provider Name (Legal Business Name): CHECK-IN CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 07/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5660 CURRY FORD RD
ORLANDO FL
32822-1445
US

IV. Provider business mailing address

7806 LAKE UNDERHILL RD SUITE 104
ORLANDO FL
32822-8232
US

V. Phone/Fax

Practice location:
  • Phone: 407-772-2727
  • Fax:
Mailing address:
  • Phone: 407-774-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME0065264
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberME0065264
License Number StateFL

VIII. Authorized Official

Name: DR. EDUARDO TOBENAS
Title or Position: OWNER/PRESIDENT
Credential: DC
Phone: 407-774-6800