| Diamond Medical Center Corporation | |
|
1650 W Sand Lake Rd Suite 108 Orlando FL 32809-7681 | |
| (407) 283-4014 | |
| (407) 601-5988 |
| Full Name | Diamond Medical Center Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 1650 W Sand Lake Rd, Orlando, Florida |
| Authorized Official Name and Position | Johnspencer Archinihu (OWNER) |
| Authorized Official Contact | 4072834014 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diamond Medical Center Corporation 1650 W Sand Lake Rd Suite 108 Orlando FL 32809-7681 Ph: (407) 283-4014 | Diamond Medical Center Corporation 1650 W Sand Lake Rd Suite 108 Orlando FL 32809-7681 Ph: (407) 283-4014 |
| NPI Number | 1346523875 |
|---|---|
| Provider Enumeration Date | 09/21/2011 |
| Last Update Date | 01/12/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346523875 | NPI | - | NPPES |
| 279671600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME68139 (Florida) | Primary |
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