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Organization

MILDRED TAVERAS TREVETT MD PA

Active
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Organization

MILDRED TAVERAS TREVETT MD PA

Active
Other names
Internal Medicine Grp of Central FL dba Lake Nona Medical Center
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID TREVETT (OFFICE ADMINISTRATOR)
(407) 802-1102
Entity
Organization

Contact information

Practice address
10437 MOSS PARK RD, ORLANDO, FL 32832
(407) 802-1100
(407) 802-1111
Mailing address
10437 MOSS PARK RD, ORLANDO, FL 32832
(407) 802-1100
(407) 802-1111

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
208M00000X
Hospitalist Physician
ME73656
FL

Other

Enumeration date
07/11/2006
Last updated
03/22/2011
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