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Organization
FLORIDIAN MEDICAL GROUP INC
Active
Organization
FLORIDIAN MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YINA FRASURE (OFFICE DIRECTOR)
(407) 744-1130
Entity
Organization
Contact information
Practice address
804 EMMETT ST, KISSIMMEE, FL 34741-5434
(407) 449-4559
(407) 588-8626
Mailing address
804 EMMETT ST, KISSIMMEE, FL 34741-5434
(407) 449-4559
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
BTR-09881
FL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
03/10/2017
Last updated
07/20/2023
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