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1507a N John Young Pkwy Kissimmee FL 34741-3214 | |
| (407) 933-8331 | |
| (407) 944-9471 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Methadone |
| Location | 1507a N John Young Pkwy, Kissimmee, Florida |
| Authorized Official Name and Position | Maria Jackson (CFO) |
| Authorized Official Contact | 4073517080 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2500 Maitland Center Parkway Suite 250 Maitland FL 32751-4174 Ph: (407) 351-7080 | 1507a N John Young Pkwy Kissimmee FL 34741-3214 Ph: (407) 933-8331 |
| NPI Number | 1780899336 |
|---|---|
| Provider Enumeration Date | 05/14/2007 |
| Last Update Date | 11/04/2022 |
| Certification Date | 11/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780899336 | NPI | - | NPPES |
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