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1699455956
FOUNTAIN LIFE ORLANDO, LLC
ORLANDO, FL
NPI
1699455956
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Entity Type
Organization
Authorized Contact
BARBARA WOO
Director Of Clinical Operations
407-725-1516
Organization Subpart ?
No
Primary Taxonomy
261Q00000X Clinic/Center
Enumeration Date
2023-07-21
Last Update Date
2023-07-21
Business Address
FOUNTAIN LIFE ORLANDO, LLC
6424 ALEXANDRA LOUISE DR STE 120
ORLANDO, FL 32827-5812
Phone number: 917-810-8672
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Mailing Address
FOUNTAIN LIFE ORLANDO, LLC
6424 ALEXANDRA LOUISE DR STE 120
ORLANDO, FL 32827-5812
Phone number: 917-810-8672
Copy
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