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General NPI Number Information
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NPI Number | 1033774724
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Entity Type | Organization
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Legal Business Name | MEDICAL TRANSITION CARE OF FLORIDA LLC
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Dates
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Enumeration Date | 05/08/2019
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Last Update Date | 08/16/2019
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Provider Practice Location Address
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Address Line | 525 TECHNOLOGY PARK STE 109
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City | LAKE MARY
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State | FL
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Zip | 32746-7107
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Country | US
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Telephone | 407-340-3533
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Fax |
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Provider Business Mailing Address
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Address Line | 2265 PICKFORD CIR
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City | APOPKA
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State | FL
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Zip | 32703-3371
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Country | US
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Telephone | 407-340-3533
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Fax | 407-537-7778
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | DEVON PALMER
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Credential |
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Telephone | 407-340-3533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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