| Premise Health Of Florida Medical, P.a. | |
|
960 Back Stage Ln Lake Buena Vista FL 32830-8472 | |
| (407) 934-4100 | |
| (407) 934-4101 |
| Full Name | Premise Health Of Florida Medical, P.a. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 960 Back Stage Ln, Lake Buena Vista, Florida |
| Authorized Official Name and Position | Jonathan Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of Florida Medical, P.a. 5500 Maryland Way Ste 120 Brentwood TN 37027-4993 Ph: () - | Premise Health Of Florida Medical, P.a. 960 Back Stage Ln Lake Buena Vista FL 32830-8472 Ph: (407) 934-4100 |
| NPI Number | 1831346642 |
|---|---|
| Provider Enumeration Date | 08/22/2008 |
| Last Update Date | 08/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831346642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |