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General NPI Number Information
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NPI Number | 1912047390
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Entity Type | Organization
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Legal Business Name | MID FLORIDA PRIMARY CARE PHYSICIANS ASSOCIATES, P.A
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1475 W US HWY 441
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City | APOPKA
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State | FL
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Zip | 32712
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Country | US
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Telephone | 407-889-8008
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Fax | 407-889-8570
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Provider Business Mailing Address
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Address Line | PO BOX 909
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City | APOPKA
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State | FL
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Zip | 32704-0909
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Country | US
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Telephone | 407-889-8008
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Fax | 407-889-8570
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEYBERTH MARIO ROSENDO
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Credential | M.D
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Telephone | 407-889-8008
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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 | ME72708
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License Number State | FL
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