Healthcare Provider Details

I. General information

NPI: 1326712233
Provider Name (Legal Business Name): XCELLENCEHEALTH MANAGEMENT GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 08/04/2021
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 S CENTRAL AVE
OVIEDO FL
32765-3276
US

IV. Provider business mailing address

5816 N DEAN RD
ORLANDO FL
32817-3249
US

V. Phone/Fax

Practice location:
  • Phone: 407-977-9779
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN GUARGUILO
Title or Position: PARTNER
Credential: PHARMD
Phone: 407-977-9779