Healthcare Provider Details

I. General information

NPI: 1437330875
Provider Name (Legal Business Name): AMERICANA MEDICAL CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5179 S JOHN YOUNG PKWY
ORLANDO FL
32839-5021
US

IV. Provider business mailing address

5179 S JOHN YOUNG PKWY
ORLANDO FL
32839-5021
US

V. Phone/Fax

Practice location:
  • Phone: 407-854-0771
  • Fax: 407-854-3195
Mailing address:
  • Phone: 407-854-0771
  • Fax: 407-854-3195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License NumberCH0005339
License Number StateFL

VIII. Authorized Official

Name: DR. MANUEL RAMIREZ
Title or Position: MEDICAL DIRECTOR
Credential: DC
Phone: 407-854-0771