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Organization
PHOENIX HEALTH ASCENDENCY LLC
Active
Organization
PHOENIX HEALTH ASCENDENCY LLC
Active
Other names
Phoenix Health
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER DIAZ (ADMINISTRATOR)
(323) 695-3822
Entity
Organization
Contact information
Practice address
17011 STATE ROAD 50 STE 103, CLERMONT, FL 34711-8203
(323) 695-3822
Mailing address
17011 STATE ROAD 50 STE 103, CLERMONT, FL 34711-8203
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2080A0000X
Pediatric Adolescent Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277908100
—
FL
Enumeration date
04/25/2023
Last updated
05/05/2023
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