Healthcare Provider Details

I. General information

NPI: 1306404124
Provider Name (Legal Business Name): MEDTON ADVANCED GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3203 LAWTON RD STE 151
ORLANDO FL
32803-2955
US

IV. Provider business mailing address

3203 LAWTON RD STE 151
ORLANDO FL
32803-2955
US

V. Phone/Fax

Practice location:
  • Phone: 407-986-6300
  • Fax: 888-503-3633
Mailing address:
  • Phone: 407-986-6300
  • Fax: 888-503-3633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LAM TON
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 407-986-6300