Organization
INTERNAL MEDICINE LLC
Active
Other names
Longwood Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
ANDY JORDAN (CREDENTIALING SPECIALIST)
(321) 206-8100
Entity
Organization
Contact information
Practice address
450 W STATE ROAD 434 STE 1010, LONGWOOD, FL 32750-5187
(407) 786-0004
(407) 636-7689
Mailing address
450 W STATE ROAD 434 STE 1010, LONGWOOD, FL 32750-5187
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
—
—
Other
Enumeration date
06/01/2022
Last updated
08/16/2024
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