Organization
ONSITE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO GANT (VP OF OPERATIONS AND COMPLIANCE)
(407) 801-2664
Entity
Organization
Contact information
Practice address
3200 W COLONIAL DR, ORLANDO, FL 32808-8023
(407) 801-2664
(877) 987-4232
Mailing address
12269 HICKORY FOREST RD, JACKSONVILLE, FL 32226-4201
(407) 801-2664
(877) 987-4232
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L14000123143
FL
Other
Enumeration date
08/17/2014
Last updated
06/22/2015
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