Organization
HUGHSTON CLINIC SOUTHEAST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA GRACE FROMKIN (DIRECTOR OF CREDENTIALING)
(706) 494-3071
Entity
Organization
Contact information
Practice address
309 N MANGOUSTINE AVE UNIT G, SANFORD, FL 32771-1098
(321) 363-1754
(321) 363-3336
Mailing address
6262 VETERANS PKWY, COLUMBUS, GA 31909-3540
(706) 494-3071
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
FL
Other
Enumeration date
07/12/2018
Last updated
08/18/2023
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