| Physicians Trust Mso, Llc | |
|
1101 N Lake Destiny Dr Suite 300 Maitland FL 32751-7114 | |
| (407) 475-9213 | |
| (407) 475-9203 |
| Full Name | Physicians Trust Mso, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1101 N Lake Destiny Dr, Maitland, Florida |
| Authorized Official Name and Position | Larry E. Jones (CEO) |
| Authorized Official Contact | 4074759213 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Physicians Trust Mso, Llc 1101 N Lake Destiny Dr Suite 300 Maitland FL 32751-7114 Ph: (407) 475-9213 | Physicians Trust Mso, Llc 1101 N Lake Destiny Dr Suite 300 Maitland FL 32751-7114 Ph: (407) 475-9213 |
| NPI Number | 1467870311 |
|---|---|
| Provider Enumeration Date | 03/28/2014 |
| Last Update Date | 03/28/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467870311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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