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General NPI Number Information
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NPI Number | 1902353485
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Entity Type | Organization
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Legal Business Name | BATSON FAMILY HEALTH CENTER FOR WELLNESS,P.A.
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 450 W STATE ROAD 434 SUITE 2020
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City | LONGWOOD
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State | FL
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Zip | 32750-5118
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Country | US
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Telephone | 407-331-7079
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Fax | 407-331-4233
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Provider Business Mailing Address
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Address Line | 450 W STATE ROAD 434 SUITE 2020
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City | LONGWOOD
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State | FL
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Zip | 32750-5118
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Country | US
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Telephone | 407-331-7079
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Fax | 407-331-4233
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES LEE BATSON
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Credential | M.D.
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Telephone | 407-621-1056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME 46662
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License Number State | FL
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