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General NPI Number Information
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NPI Number | 1699004523
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE & NEPHROLOGY, P.A.
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Dates
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Enumeration Date | 12/24/2009
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Last Update Date | 12/24/2009
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Provider Practice Location Address
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Address Line | 1400 N SEMORAN BLVD SUITE F
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City | ORLANDO
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State | FL
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Zip | 32807-3564
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Country | US
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Telephone | 407-282-2441
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Fax | 407-384-3005
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Provider Business Mailing Address
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Address Line | 1400 N SEMORAN BLVD SUITE F
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City | ORLANDO
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State | FL
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Zip | 32807-3564
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Country | US
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Telephone | 407-282-2441
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Fax | 407-384-3005
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Authorized Official
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Title or Position | PRESIDENT
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Name | JULIO GUILLERMO MOROS
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Credential | M.D.
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Telephone | 407-282-4411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 51445
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License Number State | FL
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