| |
424 Lake Howell Rd Maitland FL 32751-5907 | |
(407) 644-4595 | |
(407) 790-7752 |
Full Name | |
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Speciality | Internal Medicine |
Location | 424 Lake Howell Rd, Maitland, Florida |
Authorized Official Name and Position | Emely Edwards (OFFICE MANAGER) |
Authorized Official Contact | 4076444595 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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424 Lake Howell Rd Maitland FL 32751-5907 Ph: (407) 644-4595 | 424 Lake Howell Rd Maitland FL 32751-5907 Ph: (407) 644-4595 |
NPI Number | 1316033814 |
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Provider Enumeration Date | 10/04/2006 |
Last Update Date | 10/08/2024 |
Identifier | Type | State | Issuer |
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1316033814 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | ME0068986 (Florida) | Primary |
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