Organization
SUPREME MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHEENA MARY JOSE MD (MEDICAL DIRECTOR)
(407) 930-1030
Entity
Organization
Contact information
Practice address
10967 LAKE UNDER HILL RD, UNIT 137, ORLANDO, FL 32825-4455
(407) 930-1030
(407) 386-7277
Mailing address
10967 LAKE UNDER HILL ROAD, UNIT 137, ORLANDO, FL 32825-4455
(407) 930-1030
(407) 386-7277
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME109765
FL
Other
Enumeration date
01/25/2016
Last updated
12/23/2020
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