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General NPI Number Information
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NPI Number | 1407052848
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Entity Type | Organization
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Legal Business Name | M.J. RELIABLE INC.
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 218 W MICHIGAN ST
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City | ORLANDO
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State | FL
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Zip | 32806-4446
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Country | US
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Telephone | 407-540-1882
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Fax | 407-540-1386
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Provider Business Mailing Address
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Address Line | 218 W MICHIGAN ST
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City | ORLANDO
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State | FL
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Zip | 32806-4446
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Country | US
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Telephone | 407-540-1882
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Fax | 407-540-1386
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARGUILTA CHEREMOND
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Credential |
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Telephone | 407-291-7121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | HCC7670
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License Number State | FL
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