Organization
ALONZO J LOGAN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALONZO J LOGAN SR. MD (PST)
(407) 846-3535
Entity
Organization
Contact information
Practice address
102 PARK PL, STE D-1, KISSIMMEE, FL 34741
(407) 846-3535
Mailing address
102 PARK PL, STE D-1, KISSIMMEE, FL 34741
(407) 846-3535
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23726
FL
Other
Enumeration date
06/21/2006
Last updated
08/22/2020
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