MEDICARE: MSO OF FLORIDA, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305R00000X	Preferred Provider Organization

General Provider Information

NPI Number	:	1508216789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MSO OF FLORIDA, INC

Provider Business Mailing Address
First Line	:	PO BOX 570038
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32857-0038
Country	:	US
Telephone Number	:	407-930-1112
Fax Number	:	407-930-1114

Provider Business Practice Location Address
First Line	:	1111 S SEMORAN BLVD
Second Line	:	SUITE B
City	:	ORLANDO
State	:	FL
Zip	:	32807-1480
Country	:	US
Telephone Number	:	407-930-1112
Fax Number	:	407-930-1114

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ARCILIO ALVARADO
Credential	:
Telephone Number	:	787-306-8356

Provider Enumeration Date	:	06/17/2016
Last Update Date	:	06/17/2016

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