Provider First Line Business Practice Location Address:
11715 ORPINGTON ST STE A
Provider Second Line Business Practice Location Address:
TLC PEDIATRIC AND ADOLESCENT MEDICINE IN ASSOC WITH NEM
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32817-4600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-380-9115
Provider Business Practice Location Address Fax Number:
407-380-9189
Provider Enumeration Date:
06/08/2010