| Pha | |
|
3033 Cardillino Way Kissimmee FL 34741-7851 | |
| (321) 900-6791 | |
| (407) 201-6618 |
| Full Name | Pha |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 3033 Cardillino Way, Kissimmee, Florida |
| Authorized Official Name and Position | Choisette Damus (CEO/PRESIDENT) |
| Authorized Official Contact | 4079552324 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pha 3050 Dyer Blvd # 144 Kissimmee FL 34741-7839 Ph: (407) 955-2324 | Pha 3033 Cardillino Way Kissimmee FL 34741-7851 Ph: (321) 900-6791 |
| NPI Number | 1609412147 |
|---|---|
| Provider Enumeration Date | 11/19/2019 |
| Last Update Date | 03/09/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609412147 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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