Individual
JAVIER ANTONIO MADERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1002 N SEMORAN BLVD, ORLANDO, FL 32807-3531
(407) 275-8939
(407) 282-3674
Mailing address
613 LEGACY PARK DR, CASSELBERRY, FL 32707-2406
(407) 953-3468
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
FL
Enumeration date
04/25/2018
Last updated
04/25/2018
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