Organization · NPI-2
Preventive Medical & Diagnostic Center LLC
Preventive Medicine, Public Health & General Preventive Medicine · Kissimmee, FL
NPI number1730874058
StatusActive
Last updated in NPPESApr 11, 2023
Details
- NPI
- 1730874058
- Entity type
- Organization (NPI-2)
- Legal business name
- Preventive Medical & Diagnostic Center LLC
- Organization subpart
- No
- Enumeration date
- Apr 11, 2023
- Certification date
- Apr 11, 2023
- Last updated
- Apr 11, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2083P0901X | Preventive Medicine, Public Health & General Preventive Medicine | – | – | Yes |
Practice location
2714 Prestwick LnKissimmee, FL 34744-8527
Phone 407-764-7679
Mailing address
5008 London Creek PlKissimmee, FL 34758-2286
Phone 407-764-7679
Authorized official
Americo Ortiz
Ceo
4077647679
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