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General NPI Number Information
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NPI Number | 1861207953
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Entity Type | Organization
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Legal Business Name | FLORIDA HOSPITAL MEDICAL GROUP INC
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 2200 FOWLER GROVE BLVD STE 300
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City | WINTER GARDEN
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State | FL
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Zip | 34787-5597
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Country | US
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Telephone | 844-407-4070
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 935933
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City | ATLANTA
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State | GA
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Zip | 31193-5933
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Country | US
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Telephone | 800-737-5654
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. VANCE ALAN MCLARREN II
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Credential |
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Telephone | 407-200-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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