Organization
MAITLAND AVENUE URGENT CARE PA
Active
Other names
PA
Organization subpart
No
Provider details
NPI number
Authorized official
SETH T JOHNSON D.O. (PRESIDENT)
(321) 207-0002
Entity
Organization
Contact information
Practice address
411 MAITLAND AVE STE 1002, ALTAMONTE SPRINGS, FL 32701-5448
(321) 207-0002
(321) 207-2003
Mailing address
411 MAITLAND AVE, SUITE 1002, ALTAMONTE SPRINGS, FL 32701-5448
(321) 207-0002
(321) 207-0003
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
OS5330
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051599000
—
FL
Enumeration date
01/31/2008
Last updated
02/13/2014
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