LOYAL SOURCE GOVERNMENT SERVICES
Managed Care Organizations at Avalon Park East Blvd, Orlando, FL

License number
Florida 95000947
Category
Managed Care Organizations
Type
Health Maintenance Organization
Owner
Name: VANESSA GAMBALA NP
Title: MSN, FNP-C
Phone: (619) 301-9112
Address
Address 2
3680 Avalon Park East Blvd EAST STE 310, Orlando, FL 32828
900 Rigley St, Chula Vista, CA 91911
National Provider ID: 1487053864
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LOYAL SOURCE GOVERNMENT SERVICES LLC

Orlando, FL

Industry:
Employment Agency, General Hospital
Registration:
Jun 12, 2009
Addresses:
3680 Avalon Park East Blvd SUITE 310, Orlando, FL 32828 (Physical)
13001 Founders Sq Dr, Orlando, FL 32828
2406 Flowering Dogwood Dr, Orlando, FL 32828
State ID:
L09000057382
Business type:
Florida Limited Liability Company
Managing Members:
Seth Eubank (Managing Member), 3680 Avalon Park East Blvd, Orlando, FL 32828 (Physical),Brian F. Moore Managing Member, inactive
EIN:
30-0564703

LOYAL SOURCE GOVERNMENT SERVICES LLC

3860 Avalon Park Blvd E STE 310, Orlando, FL 32828

Registration:
Feb 17, 2015
State ID:
126420 C6
Business type:
Foreign Limited Liability Company (LLC)
Agent:
United States Corporation Agents, Inc,1888 Kalakaua Ave No C312, Honolulu, HI 96815 (Physical)

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