Provider Demographics
NPI:1407157308
Name:COMMUNITY MEDICAL CONCEPTS INC
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL CONCEPTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:S
Authorized Official - Last Name:ESTEVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-305-5165
Mailing Address - Street 1:9753 S ORANGE BLOSSOM TRL
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-7841
Mailing Address - Country:US
Mailing Address - Phone:407-922-3345
Mailing Address - Fax:
Practice Address - Street 1:9753 S ORANGE BLOSSOM TRL
Practice Address - Street 2:SUITE 106
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-7841
Practice Address - Country:US
Practice Address - Phone:407-922-3345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0067164208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty