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Organization
TEA PAIN
Active
Organization
TEA PAIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RATIBU GOMANGO (MGR)
(404) 488-6907
Entity
Organization
Contact information
Practice address
6220 S ORANGE BLOSSOM TRL, ORLANDO, FL 32809-4630
(404) 488-6907
Mailing address
7612 SUN VISTA WAY, ORLANDO, FL 32822-7501
(404) 488-6907
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
06/18/2020
Last updated
06/18/2020
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