| Impower | |
|
587 E State Road 434 Suite1021 Longwood FL 32750-5201 | |
| (407) 331-8002 | |
| (407) 331-8659 |
| Full Name | Impower |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 587 E State Road 434, Longwood, Florida |
| Authorized Official Name and Position | Lydia Oyola-diaz (CLINICIAN) |
| Authorized Official Contact | 8600837230 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impower 1065 S Kirkman Rd 132 Orlando FL 32811-3214 Ph: (860) 983-7230 | Impower 587 E State Road 434 Suite1021 Longwood FL 32750-5201 Ph: (407) 331-8002 |
| NPI Number | 1578965604 |
|---|---|
| Provider Enumeration Date | 09/19/2014 |
| Last Update Date | 09/19/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578965604 | NPI | - | NPPES |
| 3120806 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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