# SPARTAN MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Spartan Medical Men's Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003577081
- **Authorized official:** KWABENA AMPONSAH (CEO/PROVIDER)
- **Authorized official phone:** (937) 902-2068

## Contact information

- **Practice address:** 9145 NARCOOSSEE RD STE A102, ORLANDO, FL 32827-5768
- **Practice address phone:** (407) 703-6020
- **Mailing address:** 10524 MOSS PARK RD STE 204-771, ORLANDO, FL 32832-5898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 01/03/2022
- **Last updated:** 01/10/2022