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3505 Lake Lynda Dr Suite 200 Orlando FL 32817-8324 | |
| (866) 305-7365 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3505 Lake Lynda Dr, Orlando, Florida |
| Authorized Official Name and Position | Michele Desroches (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 3052819633 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8180 Nw 36th St Ste 404 Doral FL 33166-6674 Ph: (866) 305-7365 | 3505 Lake Lynda Dr Suite 200 Orlando FL 32817-8324 Ph: (866) 305-7365 |
| NPI Number | 1275922361 |
|---|---|
| Provider Enumeration Date | 01/13/2015 |
| Last Update Date | 01/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275922361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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