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809 E Oak St Ste 105 Kissimmee FL 34744-5834 | |
| (407) 483-9520 | |
| (407) 483-9551 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 809 E Oak St Ste 105, Kissimmee, Florida |
| Authorized Official Name and Position | Sergio J Aponte (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4074839540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
809 E Oak St Ste 105 Kissimmee FL 34744-5834 Ph: (407) 483-9540 | 809 E Oak St Ste 105 Kissimmee FL 34744-5834 Ph: (407) 483-9520 |
| NPI Number | 1942365804 |
|---|---|
| Provider Enumeration Date | 12/22/2006 |
| Last Update Date | 12/18/2024 |
| Certification Date | 12/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942365804 | NPI | - | NPPES |
| 684629796 | Medicaid | FL | |
| 684629798 | Medicaid | FL | |
| 010316000 | Medicaid | FL | |
| 010375100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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