Organization
OLD TOWN COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVIS FONSECA (BILLING MANAGER)
(305) 292-3600
Entity
Organization
Contact information
Practice address
3134 NORTHSIDE DR, KEY WEST, FL 33040-8004
(305) 296-8593
Mailing address
3134 NORTHSIDE DR, KEY WEST, FL 33040-8004
(305) 296-8593
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME0049975
FL
Other
Enumeration date
04/23/2007
Last updated
08/22/2020
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