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General NPI Number Information
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NPI Number | 1811310345
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Entity Type | Organization
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Legal Business Name | FIRST CARE MEDICAL GROUP
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 12/10/2018
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Provider Practice Location Address
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Address Line | 115 E LANCASTER RD STE A
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City | ORLANDO
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State | FL
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Zip | 32809
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Country | US
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Telephone | 407-888-8411
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Fax | 407-888-8371
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Provider Business Mailing Address
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Address Line | 115 E LANCASTER RD STE B
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City | ORLANDO
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State | FL
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Zip | 32809-6689
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Country | US
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Telephone | 407-888-8411
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Fax | 407-888-8371
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Authorized Official
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Title or Position | OFFICE ADMINSTRATOR
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Name | SUZY M SALOMON
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Credential | RMA
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Telephone | 407-888-8411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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