Organization
MYRTHO MOMPOINT-BRANCH MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRTHO MOMPOINT-BRANCH MD (PRESIDENT)
(407) 275-2203
Entity
Organization
Contact information
Practice address
2500 DISCOVERY DR, ORLANDO, FL 32826-3709
(407) 275-2203
(407) 282-7012
Mailing address
2500 DISCOVERY DR, ORLANDO, FL 32826-3709
(407) 275-2203
(407) 282-7012
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME73432
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46298
BCBS
FL
Enumeration date
08/12/2006
Last updated
08/22/2020
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