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Organization
WATERFORD PARK FAMILY MEDICINE
Active
Organization
WATERFORD PARK FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONLALD MALLONEE DO (OWNER)
(407) 249-3077
Entity
Organization
Contact information
Practice address
12301 LAKE UNDERHILL RD, SUITE 219, ORLANDO, FL 32828-4508
(407) 249-3077
Mailing address
PO BOX 781789, ORLANDO, FL 32878-1789
(407) 249-3077
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS6833
FL
Other
Enumeration date
04/08/2008
Last updated
10/23/2008
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