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Organization
CHANGES HEALTH, LLC
Active
Organization
CHANGES HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISMAEL A BELOSO D.O. (OWNER)
(407) 282-7300
Entity
Organization
Contact information
Practice address
12780 WATERFORD LAKES PRWY, SUITE 100, ORLANDO, FL 32828-4501
(407) 282-7300
(407) 681-4603
Mailing address
12780 WATERFORD LAKES PRWY, SUITE 100, ORLANDO, FL 32828-4501
(407) 282-7300
(407) 681-4603
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750538922
NPI
FL
01
—
OS10148
MEDICAL LICENSE
FL
Enumeration date
11/18/2013
Last updated
11/18/2013
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