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8751 Commodity Cir Suite 16 Orlando FL 32819-9027 | |
| (407) 964-1334 | |
| (407) 730-5917 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 8751 Commodity Cir, Orlando, Florida |
| Authorized Official Name and Position | Mary L Daviglus (ANESTHESIOLOGIST) |
| Authorized Official Contact | 4072406323 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8751 Commodity Cir Suite 16 Orlando FL 32819-9027 Ph: (407) 964-1334 | 8751 Commodity Cir Suite 16 Orlando FL 32819-9027 Ph: (407) 964-1334 |
| NPI Number | 1083726574 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 07/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083726574 | NPI | - | NPPES |
| 061862400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | ME0040734 (Florida) | Primary |
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