Organization
A&L FAMILY POLICLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMARILYS ROQUE BAZ APRN (MEDICAL DIRECTOR)
(407) 750-4888
Entity
Organization
Contact information
Practice address
210 E MONUMENT AVE STE C, KISSIMMEE, FL 34741-5738
(407) 750-4888
(407) 750-4188
Mailing address
210 E MONUMENT AVE STE C, KISSIMMEE, FL 34741-5738
(407) 750-4888
(407) 750-4188
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
05/08/2024
Last updated
05/28/2024
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