Organization
EDEN MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EARL G PENNANT (OWNER/PRESIDENT)
(407) 291-7466
Entity
Organization
Contact information
Practice address
5047 CLARCONA OCOEE RD, ORLANDO, FL 32810-4051
(407) 291-7466
(407) 291-0148
Mailing address
5047 CLARCONA OCOEE RD, ORLANDO, FL 32810-4051
(407) 291-7466
(407) 291-0148
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
AL 10439
FL
Other
Enumeration date
03/25/2013
Last updated
03/25/2013
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