Organization
LONGWOOD MEDICAL GROUP PA
Active
Other names
Longwood Cardiology PA
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALISA MARIE CHARACTER (BILLING OFFICE SUPERVISOR)
(407) 767-8200
Entity
Organization
Contact information
Practice address
450 W STATE ROAD 434, STE 301, LONGWOOD, FL 32750-5187
(407) 767-8200
(407) 767-0476
Mailing address
450 W STATE RD 434, STE 301, LONGWOOD, FL 32750
(407) 767-8200
(407) 767-0476
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME79324
FL
207RC0000X
Cardiovascular Disease Physician
Primary
ME78066
FL
Other
Enumeration date
09/05/2007
Last updated
05/01/2018
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