# MINIER WATERFORD LAKES LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417155730
- **Authorized official:** SANFORD K BOAZ ARNP (CEO)
- **Authorized official phone:** (407) 257-5782

## Contact information

- **Practice address:** 12301 LAKE UNDERHILL RD STE 118, ORLANDO, FL 32828-4510
- **Practice address phone:** (407) 249-8870
- **Practice address fax:** (407) 249-8871
- **Mailing address:** 12301 LAKE UNDERHILL RD STE 118, ORLANDO, FL 32828-4510
- **Mailing address phone:** (407) 249-8870
- **Mailing address fax:** (407) 249-8871

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/08/2007
- **Last updated:** 06/05/2008