Organization
HUGHSTON CLINIC SOUTHEAST, PC
Active
Parent organization
HUGHSTON CLINIC SOUTHEAST PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HUGHSTON CLINIC SOUTHEAST PC
Authorized official
AMANDA FROMKIN (CREDENTIALING MANAGER)
(706) 570-0220
Entity
Organization
Contact information
Practice address
819 E OAK ST STE A, KISSIMMEE, FL 34744-5842
(407) 476-0780
(407) 476-0785
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 570-0220
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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