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Organization
SPARTAN MEDICAL GROUP
Active
Organization
SPARTAN MEDICAL GROUP
Active
Other names
Spartan Medical Men's Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
KWABENA AMPONSAH (CEO/PROVIDER)
(937) 902-2068
Entity
Organization
Contact information
Practice address
9145 NARCOOSSEE RD STE A102, ORLANDO, FL 32827-5768
(407) 703-6020
Mailing address
10524 MOSS PARK RD STE 204-771, ORLANDO, FL 32832-5898
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
01/03/2022
Last updated
01/10/2022
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