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Organization

MEDICAL VILLAGE HEALTHCARE GROUP

Active
Parent organization
MEDICAL VILLAGE HEALTHCARE GROUP
Organization subpart
Yes

Provider details

NPI number
Legal business name
MEDICAL VILLAGE HEALTHCARE GROUP
Authorized official
DR. KHALID MANZUR MD (PRESIDENT)
(407) 888-6990
Entity
Organization

Contact information

Practice address
1462 W OAK RIDGE RD, ORLANDO, FL 32809-3905
(407) 888-6990
(407) 888-3310
Mailing address
816 W OAK ST, KISSIMMEE, FL 34741-6625
(407) 944-9777

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME81287
FL
208000000X
Pediatrics Physician
Primary
ME81287
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1376516575
INDIVIDUAL PROVIDER NPI
FL
01
1447223193
INDIVIDUAL PROVIDER NPI
FL
Enumeration date
01/31/2009
Last updated
02/02/2009
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