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Organization
MEDICAL HOME ALLIANCE LLC
Active
Organization
MEDICAL HOME ALLIANCE LLC
Active
Parent organization
MEDICAL HOME ALLIANCE LLC
Other names
IMA Medical Group - Favilli
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDICAL HOME ALLIANCE LLC
Authorized official
VANESSA HOURIHAN (VP REVENUE CYCLE)
(407) 845-0322
Entity
Organization
Contact information
Practice address
3650 INNOVATION DR, LAKELAND, FL 33812-4105
(863) 646-6295
(863) 701-2151
Mailing address
6675 WESTWOOD BLVD STE 475, ORLANDO, FL 32821-6027
(407) 845-0330
(888) 972-1752
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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