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6000 Lake Ellenor Dr Orlando FL 32809-4615 | |
| (754) 300-3120 | |
| (888) 919-4431 |
| Full Name | |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 6000 Lake Ellenor Dr, Orlando, Florida |
| Authorized Official Name and Position | Belina Surujon (LICENSING & CONTRACTING DIRECTOR) |
| Authorized Official Contact | 3057855520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
100 Se 3rd Ave Suite 1800 Fort Lauderdale FL 33394-0002 Ph: (754) 300-3120 | 6000 Lake Ellenor Dr Orlando FL 32809-4615 Ph: (754) 300-3120 |
| NPI Number | 1073909560 |
|---|---|
| Provider Enumeration Date | 04/10/2015 |
| Last Update Date | 08/09/2024 |
| Certification Date | 08/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073909560 | NPI | - | NPPES |
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