Organization
VINE THERAPY CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. IDELFONSO MOREJON MA (PRESIDENT)
(407) 201-4932
Entity
Organization
Contact information
Practice address
419 W VINE ST, KISSIMMEE, FL 34741-4154
(407) 201-4932
(407) 350-5996
Mailing address
419 W VINE ST, KISSIMMEE, FL 34741-4154
(407) 201-4932
(407) 350-5996
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
M55648
FL
Other
Enumeration date
11/14/2009
Last updated
11/14/2009
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