| Magic Medical Group Inc. | |
|
9421 S Orange Blossom Trl Ste 19 Orlando FL 32837-8320 | |
| (407) 601-2527 | |
| (407) 674-7640 |
| Full Name | Magic Medical Group Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 9421 S Orange Blossom Trl Ste 19, Orlando, Florida |
| Authorized Official Name and Position | Larry De Jesus (PRESIDENT) |
| Authorized Official Contact | 7865181911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magic Medical Group Inc. 9421 S Orange Blossom Trl Ste 19 Orlando FL 32837-8320 Ph: (407) 601-2527 | Magic Medical Group Inc. 9421 S Orange Blossom Trl Ste 19 Orlando FL 32837-8320 Ph: (407) 601-2527 |
| NPI Number | 1730646787 |
|---|---|
| Provider Enumeration Date | 02/26/2019 |
| Last Update Date | 07/14/2020 |
| Certification Date | 07/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730646787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 207R00000X | Internal Medicine | () | Secondary |
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