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Organization
MEDICAL HOME ALLIANCE LLC
Active
Organization
MEDICAL HOME ALLIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZENEIDA TAVAREZ (CREDENTIALING SPECIALIST)
(917) 495-7496
Entity
Organization
Contact information
Practice address
130 RIDGE CENTER DR STE 104, DAVENPORT, FL 33837-6414
(863) 421-9447
(863) 421-1806
Mailing address
2675 WINKLER AVE STE 200, FORT MYERS, FL 33901-9328
(877) 856-3774
(239) 599-2625
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
01/10/2013
Last updated
02/26/2026
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