# PREVENTIVE MEDICAL & DIAGNOSTIC CENTER LLC

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

## Provider details

- **NPI number:** 1730874058
- **Authorized official:** MR. AMERICO ORTIZ (CEO)
- **Authorized official phone:** (407) 764-7679

## Contact information

- **Practice address:** 2714 PRESTWICK LN, KISSIMMEE, FL 34744-8527
- **Practice address phone:** (407) 764-7679
- **Mailing address:** 5008 LONDON CREEK PL, KISSIMMEE, FL 34758-2286
- **Mailing address phone:** (407) 764-7679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | Yes |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/11/2023
- **Last updated:** 04/11/2023