Organization
FMIC 2, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN O GONZALEZ (ADMINISTRATOR)
(407) 944-9355
Entity
Organization
Contact information
Practice address
2470 E HIGHWAY 50 STE B, CLERMONT, FL 34711-6016
(407) 944-9355
(407) 933-1237
Mailing address
322 N JOHN YOUNG PKWY, KISSIMMEE, FL 34741-4902
(407) 944-9355
(407) 933-1237
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/01/2019
Last updated
12/01/2019
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