| Waterford Park Family Medicine | |
|
12301 Lake Underhill Rd Suite 219 Orlando FL 32828-4508 | |
| (407) 249-3077 | |
| Not Available |
| Full Name | Waterford Park Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 12301 Lake Underhill Rd, Orlando, Florida |
| Authorized Official Name and Position | Ronlald Mallonee (OWNER) |
| Authorized Official Contact | 4072493077 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waterford Park Family Medicine Po Box 781789 Orlando FL 32878-1789 Ph: (407) 249-3077 | Waterford Park Family Medicine 12301 Lake Underhill Rd Suite 219 Orlando FL 32828-4508 Ph: (407) 249-3077 |
| NPI Number | 1922271261 |
|---|---|
| Provider Enumeration Date | 04/08/2008 |
| Last Update Date | 10/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922271261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS6833 (Florida) | Primary |
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