Provider First Line Business Practice Location Address:
4000 CENTRAL FLORIDA BLVD
Provider Second Line Business Practice Location Address:
UCF SPORTS MEDICINE
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32816-3555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-823-0963
Provider Business Practice Location Address Fax Number:
407-823-6744
Provider Enumeration Date:
03/16/2010