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Organization

CENTRAL FLORIDA INJURY SOUTHWEST, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEROLD J FADEM JR. M.D. (PHYSICIAN)
(407) 578-2351
Entity
Organization

Contact information

Practice address
882 S KIRKMAN RD STE 101, ORLANDO, FL 32811-2652
(407) 578-2350
(407) 264-8300
Mailing address
882 S KIRKMAN RD STE 101, ORLANDO, FL 32811-2652
(407) 578-2350
(407) 264-8300

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
FL
207R00000X
Internal Medicine Physician
FL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
FL

Other

Enumeration date
11/09/2009
Last updated
06/08/2016
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