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General NPI Number Information
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NPI Number | 1700461720
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Entity Type | Organization
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Legal Business Name | PROFICIENT SHIFT L.L.C.
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Dates
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Enumeration Date | 03/11/2021
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Last Update Date | 03/11/2021
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Provider Practice Location Address
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Address Line | 215 ANNIE ST
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City | ORLANDO
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State | FL
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Zip | 32806
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Country | US
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Telephone | 407-346-8577
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Fax |
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Provider Business Mailing Address
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Address Line | 2212 S CHICKASAW TRL STE 1173
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City | ORLANDO
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State | FL
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Zip | 32825-8414
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Country | US
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Telephone | 407-346-8577
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. TEDDY BERNARD
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Credential |
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Telephone | 407-346-8577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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