| Regenerative Medicine Space Coast Llc | |
|
954 Lake Baldwin Ln Orlando FL 32814-6651 | |
| (407) 315-2271 | |
| Not Available |
| Full Name | Regenerative Medicine Space Coast Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 954 Lake Baldwin Ln, Orlando, Florida |
| Authorized Official Name and Position | Rafael Foss (OWNER) |
| Authorized Official Contact | 7863701111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Regenerative Medicine Space Coast Llc Po Box 24556 Jacksonville FL 32241-4556 Ph: () - | Regenerative Medicine Space Coast Llc 954 Lake Baldwin Ln Orlando FL 32814-6651 Ph: (407) 315-2271 |
| NPI Number | 1760246656 |
|---|---|
| Provider Enumeration Date | 02/12/2024 |
| Last Update Date | 02/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760246656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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