Organization
MINIER WATERFORD LAKES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANFORD K BOAZ ARNP (CEO)
(407) 257-5782
Entity
Organization
Contact information
Practice address
12301 LAKE UNDERHILL RD STE 118, ORLANDO, FL 32828-4510
(407) 249-8870
(407) 249-8871
Mailing address
12301 LAKE UNDERHILL RD STE 118, ORLANDO, FL 32828-4510
(407) 249-8870
(407) 249-8871
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/08/2007
Last updated
06/05/2008
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