Healthcare Provider Details

I. General information

NPI: 1508449075
Provider Name (Legal Business Name): CONTEMPORARY HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 05/03/2021
Certification Date: 05/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 W COLONIAL DR
ORLANDO FL
32804-6863
US

IV. Provider business mailing address

10129 CLEAR VISTA ST
ORLANDO FL
32832-7164
US

V. Phone/Fax

Practice location:
  • Phone: 407-601-4370
  • Fax: 407-386-3414
Mailing address:
  • Phone: 407-601-1370
  • Fax: 407-386-3414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LUIS ALLEN
Title or Position: AUTHORIZED OFFICIAIL
Credential: MD
Phone: 407-601-1370