Organization
EXCELLON CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID CHEESMAN D.O. (OWNER)
(321) 354-5250
Entity
Organization
Contact information
Practice address
8015 TURKEY LAKE RD STE 300, ORLANDO, FL 32819-7383
(407) 334-4359
Mailing address
7557 W SAND LAKE RD # 167, ORLANDO, FL 32819-5109
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01054637A
IN
207Q00000X
Family Medicine Physician
Primary
OS4187
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS4187
STATE LICENSE
FL
Enumeration date
05/13/2013
Last updated
05/15/2013
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