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Organization
PHYSICIAN NEXT DOOR, LLC
Active
Organization
PHYSICIAN NEXT DOOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GABRIEL NURIEL (AUTHORIZED OFFICIAL / SHAREHOLDER)
(941) 870-0199
Entity
Organization
Contact information
Practice address
1834 N ALAFAYA TRL, STE C, ORLANDO, FL 32826-4743
(941) 870-0199
(941) 870-0203
Mailing address
1834 N ALAFAYA TRL, STE C, ORLANDO, FL 32826-4743
(941) 870-0199
(941) 870-0203
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
OS7691
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HM571A
MEDICARE PTAN
FL
Enumeration date
10/29/2012
Last updated
06/24/2015
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