Organization Name: | ALOMA WALK IN CLINIC |
NPI Number: | 1033500103 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AHMAD SHOKOOHI (OWNER) |
Mailing Address: | 7480 Aloma Ave Winter Park |
State: | FL US |
Postal Code: | 327929102 |
Phone Number: | 4076577799 |
Fax Number: | 4076577928 |
NPI Enumeration Date: | 02/11/2015 |
NPI Last Update Date: | 02/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207QA0505X |
License Number: | ME33049 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Family Medicine |
Taxonomy Specialization: | Adult Medicine |
Taxonomy Definition: |