Healthcare Provider Details

I. General information

NPI: 1508216789
Provider Name (Legal Business Name): MSO OF FLORIDA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2016
Last Update Date: 06/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 S SEMORAN BLVD SUITE B
ORLANDO FL
32807-1480
US

IV. Provider business mailing address

PO BOX 570038
ORLANDO FL
32857-0038
US

V. Phone/Fax

Practice location:
  • Phone: 407-930-1112
  • Fax: 407-930-1114
Mailing address:
  • Phone: 407-930-1112
  • Fax: 407-930-1114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: DR. ARCILIO ALVARADO
Title or Position: PRESIDENT
Credential:
Phone: 787-306-8356