Organization
REGENERATIVE MEDICINE SPACE COAST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL FOSS DC (OWNER)
(786) 370-1111
Entity
Organization
Contact information
Practice address
954 LAKE BALDWIN LN, ORLANDO, FL 32814-6651
(407) 315-2271
Mailing address
PO BOX 24556, JACKSONVILLE, FL 32241-4556
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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