Organization
ACTIVE DL SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARAIVYS GONZALEZ PEREZ (OWNER)
(407) 480-1635
Entity
Organization
Contact information
Practice address
1830 BEL AIR AVE, ORLANDO, FL 32812-8709
(407) 480-1635
Mailing address
1830 BEL AIR AVE, ORLANDO, FL 32812-8709
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
07/09/2020
Last updated
07/09/2020
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