Provider Demographics
NPI:1245617026
Name:A PLUS CENTRAL FLORIDA HEALTH CARE LLC
Entity Type:Organization
Organization Name:A PLUS CENTRAL FLORIDA HEALTH CARE LLC
Other - Org Name:OMNI MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:JUNIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-705-3636
Mailing Address - Street 1:425 S HUNT CLUB BLVD
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-4947
Mailing Address - Country:US
Mailing Address - Phone:407-705-3636
Mailing Address - Fax:407-809-5222
Practice Address - Street 1:425 S HUNT CLUB BLVD
Practice Address - Street 2:SUITE 2001
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-4947
Practice Address - Country:US
Practice Address - Phone:407-705-3636
Practice Address - Fax:407-809-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86952207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH84583Medicare PIN