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668 N Orlando Ave Ste 1018 Maitland FL 32751-4473 | |
| (818) 571-7296 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 668 N Orlando Ave, Maitland, Florida |
| Authorized Official Name and Position | Gene E Wei (DIRECTOR) |
| Authorized Official Contact | 8185717296 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
668 N Orlando Ave Ste 1018 Maitland FL 32751-4473 Ph: (818) 571-7296 | 668 N Orlando Ave Ste 1018 Maitland FL 32751-4473 Ph: (818) 571-7296 |
| NPI Number | 1114331584 |
|---|---|
| Provider Enumeration Date | 06/13/2014 |
| Last Update Date | 06/13/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114331584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
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