Organization
SIP & DRIP IV LOUNGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAEDRA GREENIDGE RN (OWNER/OPERATOR)
(407) 415-6061
Entity
Organization
Contact information
Practice address
6100 LAKE ELLENOR DR STE 202, ORLANDO, FL 32809-4632
(407) 415-6061
Mailing address
6100 LAKE ELLENOR DR STE 202, ORLANDO, FL 32809-4632
(407) 415-6061
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
Primary
—
—
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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