Healthcare Provider Details

I. General information

NPI: 1194644708
Provider Name (Legal Business Name): LA FAMILLE MEDICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9702 UNIVERSAL BLVD
ORLANDO FL
32819-8721
US

IV. Provider business mailing address

9702 UNIVERSAL BLVD
ORLANDO FL
32819-8721
US

V. Phone/Fax

Practice location:
  • Phone: 786-424-1860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ERNESTO ZAMBRANO CASTILLO
Title or Position: CEO
Credential:
Phone: 786-424-1860