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General NPI Number Information
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NPI Number | 1659724441
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Entity Type | Organization
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Legal Business Name | FLORIDA ORTHO ER LLC
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Dates
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Enumeration Date | 07/18/2016
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Last Update Date | 07/18/2016
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Provider Practice Location Address
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Address Line | 3607 ALOMA AVE STE 1081
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City | OVIEDO
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State | FL
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Zip | 32765-8856
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Country | US
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Telephone | 407-747-7236
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Fax |
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Provider Business Mailing Address
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Address Line | 1536 PLANTATION POINTE DR
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City | ORLANDO
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State | FL
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Zip | 32824-4840
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Country | US
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Telephone | 407-747-7236
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | DR. JUAN CARLOS CARLOS MORENO
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Credential |
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Telephone | 407-747-7236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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