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Organization
ORIGINS FUNCTIONAL MEDICINE, LLC
Active
Organization
ORIGINS FUNCTIONAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA MATTEOLI DO (OWNER)
(407) 902-4912
Entity
Organization
Contact information
Practice address
260 LOOKOUT PL STE 106, MAITLAND, FL 32751-4485
(407) 902-1942
Mailing address
260 LOOKOUT PL STE 106, MAITLAND, FL 32751-4485
(407) 902-1942
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS13606
FL
Other
Enumeration date
03/01/2016
Last updated
03/01/2016
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