Organization
F.S.T. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY BENNETT (REGISTERED AGENT/MANAGER)
(407) 265-1888
Entity
Organization
Contact information
Practice address
212 W BAY AVE, LONGWOOD, FL 32750-4126
(407) 265-1888
Mailing address
212 W BAY AVE, LONGWOOD, FL 32750-4126
(407) 265-1888
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/02/2013
Last updated
08/02/2013
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