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Organization

CENTRAL FLORIDA INJURY EAST, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEROLD J FADEM JR. M.D. (MEDICAL DIRECTOR)
(407) 275-9334
Entity
Organization

Contact information

Practice address
5555 E MICHIGAN ST, SUITE 102, ORLANDO, FL 32822-2700
(407) 275-9334
(407) 275-9395
Mailing address
5555 E MICHIGAN ST, SUITE 102, ORLANDO, FL 32822-2700
(407) 275-9334
(407) 275-9395

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME 75343
FL
208D00000X
General Practice Physician
ME 8351
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1023141819
NPI
FL
Enumeration date
03/13/2007
Last updated
12/06/2016
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