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NPI Code Detail

MEDICARE: MEDICAL HOME ALLIANCE LLC

MEDICARE: MEDICAL HOME ALLIANCE LLC
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
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1952075368
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL HOME ALLIANCE LLC
Provider Business Mailing Address
First Line : 6675 WESTWOOD BLVD STE 475
Second Line :
City : ORLANDO
State : FL
Zip : 32821-6027
Country : US
Telephone Number : 407-845-0330
Fax Number : 888-972-1752
Provider Business Practice Location Address
First Line : 1044 PLAZA DR
Second Line :
City : KISSIMMEE
State : FL
Zip : 34743-4064
Country : US
Telephone Number : 407-350-5659
Fax Number : 407-350-5662
Authorized Official
Title or Position : VP REVENUE CYCLE
Name : VANESSA HOURIHAN
Credential :
Telephone Number : 407-845-0322
Provider Enumeration Date : 08/09/2021
Last Update Date : 08/09/2021

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Directions to “MEDICAL HOME ALLIANCE LLC ” Practice Location

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