Organization
MEDVITAL PHYSICIAN CARE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAADIA FERSOBE MD (MEDICAL DIRECTOR)
(407) 847-5805
Entity
Organization
Contact information
Practice address
102 PARK PLACE BLVD, KISSIMMEE, FL 34741-2358
(407) 847-5805
Mailing address
102 PARK PLACE BLVD, KISSIMMEE, FL 34741-2358
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
ACN684
FL
Other
Enumeration date
08/20/2016
Last updated
08/20/2016
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