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General NPI Number Information
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NPI Number | 1093509077
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Entity Type | Individual
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Provider Name | MR. VAUGHN LEON MCCALL SR.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 103 N WYMORE RD
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City | EATONVILLE
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State | FL
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Zip | 32751-6104
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Country | US
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Telephone | 407-617-0673
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Fax |
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Provider Business Mailing Address
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Address Line | 103 N WYMORE RD
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City | EATONVILLE
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State | FL
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Zip | 32751-6104
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Country | US
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Telephone | 407-617-0673
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number | CL0186026
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License Number State | FL
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