| Medical Village Healthcare Group | |
|
1462 W Oak Ridge Rd Orlando FL 32809-3905 | |
| (407) 888-6990 | |
| (407) 888-3310 |
| Full Name | Medical Village Healthcare Group |
|---|---|
| Speciality | Pediatrics |
| Location | 1462 W Oak Ridge Rd, Orlando, Florida |
| Authorized Official Name and Position | Khalid Manzur (PRESIDENT) |
| Authorized Official Contact | 4078886990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Village Healthcare Group 816 W Oak St Kissimmee FL 34741-6625 Ph: (407) 944-9777 | Medical Village Healthcare Group 1462 W Oak Ridge Rd Orlando FL 32809-3905 Ph: (407) 888-6990 |
| NPI Number | 1861630626 |
|---|---|
| Provider Enumeration Date | 01/31/2009 |
| Last Update Date | 02/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861630626 | NPI | - | NPPES |
| 1376516575 | Other | FL | INDIVIDUAL PROVIDER NPI |
| 1447223193 | Other | FL | INDIVIDUAL PROVIDER NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME81287 (Florida) | Secondary |
| 208000000X | Pediatrics | ME81287 (Florida) | Primary |
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