Organization
CENTRAL FLORIDA DREAMPLEX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY JO GOMES (PRESIDENT)
(352) 406-0922
Entity
Organization
Contact information
Practice address
2400 S HIGHWAY 27 STE B201, CLERMONT, FL 34711-6816
(352) 394-0212
(352) 241-6361
Mailing address
PO BOX 120547, CLERMONT, FL 34712-0547
(352) 394-0212
(352) 241-6361
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
811908200
—
FL
Enumeration date
04/23/2008
Last updated
03/26/2020
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