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General NPI Number Information
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NPI Number | 1033570171
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Entity Type | Organization
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Legal Business Name | RELIANCE MED, LLC
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Dates
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Enumeration Date | 03/17/2016
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Last Update Date | 03/17/2016
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Provider Practice Location Address
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Address Line | 8450 REYMONT ST
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City | ORLANDO
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State | FL
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Zip | 32827-7430
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Country | US
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Telephone | 407-928-5766
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Fax |
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Provider Business Mailing Address
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Address Line | 8450 REYMONT ST
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City | ORLANDO
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State | FL
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Zip | 32827-7430
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Country | US
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Telephone | 407-928-5766
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. FELIPE COLLAZO-PAGAN
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Credential | M.D.
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Telephone | 407-928-5766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | ME79942
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License Number State | FL
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