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Organization

LEGACY V MEDICAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIE L MARCOVITCH (MGR. MEMBER)
(407) 674-8988
Entity
Organization

Contact information

Practice address
3113 WILLIE MAYS PKWY, STE.1100-B, ORLANDO, FL 32811
(407) 947-4946
Mailing address
3113 WILLIE MAYS PKWY, STE.1100-B, ORLANDO, FL 32811
(407) 674-8988
(407) 674-8993

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary

Other

Enumeration date
12/28/2010
Last updated
05/05/2011
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