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General NPI Number Information
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NPI Number | 1407234099
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Entity Type | Organization
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Legal Business Name | HNC MEDICAL LLC
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Dates
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Enumeration Date | 05/14/2015
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Last Update Date | 05/14/2015
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Provider Practice Location Address
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Address Line | 13000 AVALON LAKE DR STE 100
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City | ORLANDO
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State | FL
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Zip | 32828-6434
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Country | US
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Telephone | 407-808-8763
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Fax | 407-978-6507
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Provider Business Mailing Address
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Address Line | 2423 S ORANGE AVE 139
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City | ORLANDO
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State | FL
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Zip | 32806-4543
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Country | US
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Telephone | 407-808-8763
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Fax | 407-978-6507
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE HUDSON
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Credential | D.O.
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Telephone | 407-808-8763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS5964
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License Number State | FL
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