PHYSIOCARE MEDICAL & WELLNESS CENTER
Managed Care Organizations at Crystal Clear Ln, Orlando, FL

License number
Florida HCC5023
Category
Managed Care Organizations
Type
Health Maintenance Organization
Owner
Name: DR. FREDERIC J FREEMAN II D.C.
Title: MEDICAL DIRECTOR
Phone: (407) 240-8884
Address
Address
8204 Crystal Clear Ln SUITE 1500, Orlando, FL 32809
National Provider ID: 1467684878
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PHYSIOCARE MEDICAL & WELLNESS CENTER, INC

Orlando, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Doing business as:
Physiocare Medical & Wellness
Inactive reason:
NAME CHANGE AMENDMENT
Registration:
Dec 11, 2002
Inactive since:
Sep 12, 2005
Phone:
(407) 240-8884 (Phone), (407) 240-8388 (Fax)
Addresses:
8204 Crystal Clear Ln SUITE 1500, Orlando, FL 32809 (Physical)
Orlando, FL 32877 (Mailing)
PO Box 771977, Orlando, FL 32877
State ID:
P02000130606
Business type:
Florida Profit Corporation
Director:
John Arboleda (Director), 8204 Crystal Clear Ln SUITE 1500, Orlando, FL 32809 (Physical)
Agent:
John, Arboleda,8204 Crystal Clear Ln SUITE 1500, Orlando, FL 32809 (Physical)
EIN:
61-1437137

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