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General NPI Number Information
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NPI Number | 1548210180
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Entity Type | Organization
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Legal Business Name | DELOS CLIFT MD PA
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 3000 N ORANGE AVE SUITE A
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City | ORLANDO
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State | FL
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Zip | 32804-7613
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Country | US
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Telephone | 407-472-0840
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Fax | 407-472-0841
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Provider Business Mailing Address
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Address Line | 3000 N ORANGE AVE SUITE A
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City | ORLANDO
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State | FL
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Zip | 32804-7613
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Country | US
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Telephone | 407-472-0840
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Fax | 407-472-0841
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CATHY BENITEZ
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Credential |
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Telephone | 407-472-0840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | ME60789
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License Number State | FL
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