Organization
PRESTIGE MEDICAL SERVICES & REHAB CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS NEREIDA INFANTE (MANAGER)
(407) 897-1135
Entity
Organization
Contact information
Practice address
2614 E COLONIAL DR, SUITE 400-5, ORLANDO, FL 32803-5028
(407) 897-1135
(407) 897-1136
Mailing address
2614 E COLONIAL DR, SUITE 400-5, ORLANDO, FL 32803-5028
(407) 897-1135
(407) 897-1136
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
HCC9454
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008337700
—
FL
01
—
GM816A
MEDICARE PTAN
FL
Enumeration date
02/15/2012
Last updated
04/21/2014
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