Organization Name: | CHANGES HEALTH, LLC |
NPI Number: | 1841620531 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ISMAEL A BELOSO (OWNER) |
Mailing Address: | 12780 Waterford Lakes Prwy Suite 100 Orlando |
State: | FL US |
Postal Code: | 328284501 |
Phone Number: | 4072827300 |
Fax Number: | 4076814603 |
NPI Enumeration Date: | 11/18/2013 |
NPI Last Update Date: | 11/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |