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NPI 1780959783

NPI 1780959783 : AIDS HEALTHCARE FOUNDATION : ORLANDO, FL

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General NPI Number Information
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    NPI Number           |    1780959783
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    Entity Type          |    Organization 
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    Legal Business Name  |    AIDS HEALTHCARE FOUNDATION 
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Dates
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    Enumeration Date     |    03/09/2012
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    Last Update Date     |    09/11/2019
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Provider Practice Location Address
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    Address Line         |    1516 E COLONIAL DR SUITE 210
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    City                 |    ORLANDO
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    State                |    FL
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    Zip                  |    32803-4740
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    Country              |    US
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    Telephone            |    407-447-1670
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    Fax                  |    407-447-1671
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Provider Business Mailing Address
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    Address Line         |    6255 W SUNSET BLVD FL 21 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90028-7422
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    Country              |    US
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    Telephone            |    323-860-5200
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    Fax                  |    883-241-7615
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Authorized Official
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    Title or Position    |    CHIEF OF MANAGED CARE
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    Name                 |     DONNA  STIDHAM 
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    Credential           |    
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    Telephone            |    323-436-5025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207R00000X
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    Taxonomy Name        |    Internal Medicine Physician
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    License Number       |    
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    License Number State |    
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