| |
1000 Emmett St Ste 102, Kissimmee, FL 34741-3605 | |
(407) 913-1010 | |
(407) 992-8697 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center |
Location | 1000 Emmett St Ste 102, Kissimmee, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053641001 | NPI | - | NPPES |
001711400 | Medicaid | FL | |
106018400 | Medicaid | FL | |
001711401 | Medicaid | FL |
Mailing Address | Practice Location Address |
---|---|
1000 Emmett St Ste 102, Kissimmee, FL 34741-3605 Ph: (407) 913-1010 | 1000 Emmett St Ste 102, Kissimmee, FL 34741-3605 Ph: (407) 913-1010 |