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Organization

PHYSICIAN NEXT DOOR

Active
Parent organization
PHYSICIAN NEXT DOOR
Other names
physician Next Door Poinciana
Organization subpart
Yes

Provider details

NPI number
Legal business name
PHYSICIAN NEXT DOOR
Authorized official
JACKIE FUENTES (BILLING MANAGER)
(786) 546-3714
Entity
Organization

Contact information

Practice address
339 CYPRESS PKWY STE 110, KISSIMMEE, FL 34759-3315
(407) 343-0542
Mailing address
1969 S ALAFAYA TRL # 128, ORLANDO, FL 32828-8732
(407) 343-0542
(407) 343-0553

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
305S00000X
Point of Service

Other

Enumeration date
01/27/2016
Last updated
01/27/2016
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