Organization
MAGIC MEDICAL SPECIALTIES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY DE JESUS (OWNER)
(786) 518-1911
Entity
Organization
Contact information
Practice address
9421 S ORANGE BLOSSOM TRL # 19, ORLANDO, FL 32837-8320
(407) 601-2527
(407) 674-7640
Mailing address
9421 S ORANGE BLOSSOM TRL # 19, ORLANDO, FL 32837-8320
(407) 601-2527
(407) 674-7640
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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