Fmic 2, LLC
Clinic/Center in Clermont, FL. Organization (NPI-2).
NPI number1982241600
StatusActive
Last updated in NPPESDec 1, 2019
Details
- NPI
- 1982241600
- Entity type
- Organization (NPI-2)
- Legal business name
- Fmic 2, LLC
- Organization subpart
- No
- Enumeration date
- Dec 1, 2019
- Last updated
- Dec 1, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
Practice location
2470 E Highway 50 Ste BClermont, FL 34711-6016
Phone 407-944-9355 · Fax 407-933-1237
Mailing address
322 N John Young PkwyKissimmee, FL 34741-4902
Phone 407-944-9355 · Fax 407-933-1237
Authorized official
Carmen O Gonzalez
Administrator
4079449355
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