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General NPI Number Information
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NPI Number | 1457616807
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Entity Type | Organization
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Legal Business Name | FLEMING MEDICAL CENTER, INC
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 05/24/2013
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Provider Practice Location Address
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Address Line | 1203 CLEVELAND AVE SUITE 1A
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City | EAST POINT
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State | GA
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Zip | 30344-3417
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Country | US
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Telephone | 678-886-8665
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Fax |
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Provider Business Mailing Address
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Address Line | 1203 CLEVELAND AVE SUITE 1A
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City | EAST POINT
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State | GA
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Zip | 30344-3417
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Country | US
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Telephone | 678-886-8665
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JUAN DIEGO ROMERO
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Credential |
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Telephone | 678-886-8665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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