Provider First Line Business Practice Location Address:
200 N LAKEMONT AVE
Provider Second Line Business Practice Location Address:
PEDIATRIC INPT CARE AT WINTER PARK
Provider Business Practice Location Address City Name:
WINTER PARK
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32792-3273
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-303-2528
Provider Business Practice Location Address Fax Number:
407-303-2760
Provider Enumeration Date:
07/20/2011