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General NPI Number Information
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NPI Number | 1376785980
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Entity Type | Organization
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Legal Business Name | JENNIFER LANDA, LLC OF FLORIDA
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 03/27/2009
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Provider Practice Location Address
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Address Line | 175 LOOKOUT PL SUITE 201
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City | MAITLAND
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State | FL
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Zip | 32751-8434
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Country | US
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Telephone | 888-799-5821
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Fax | 866-402-5245
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Provider Business Mailing Address
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Address Line | 3039 CECELIA DR
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City | APOPKA
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State | FL
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Zip | 32703-7813
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Country | US
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Telephone | 888-799-5821
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Fax | 866-402-5245
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Authorized Official
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Title or Position | DIRECTOR
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Name | JENNIFER LANDA
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Credential | M.D.
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Telephone | 888-799-5821
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME97938
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License Number State | FL
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