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General NPI Number Information
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NPI Number | 1407157308
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Entity Type | Organization
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Legal Business Name | COMMUNITY MEDICAL CONCEPTS INC
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Dates
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Enumeration Date | 11/09/2010
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Last Update Date | 12/23/2010
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Provider Practice Location Address
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Address Line | 9753 S ORANGE BLOSSOM TRL SUITE 106
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City | ORLANDO
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State | FL
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Zip | 32837-7841
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Country | US
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Telephone | 407-922-3345
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Fax |
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Provider Business Mailing Address
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Address Line | 9753 S ORANGE BLOSSOM TRL SUITE 106
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City | ORLANDO
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State | FL
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Zip | 32837-7841
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Country | US
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Telephone | 407-922-3345
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. ANDRE S. ESTEVEZ
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Credential |
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Telephone | 305-305-5165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME 0067164
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License Number State | FL
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