Individual
EDISON URRUTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
222 BROADWAY UNIT 211, KISSIMMEE, FL 34741-5760
(407) 329-3464
Mailing address
3003 CONNER LN, KISSIMMEE, FL 34741-7727
(321) 846-3189
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/29/2020
Last updated
02/29/2020
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