Provider Demographics
NPI:1730491994
Name:MEDICAL CONSULTANT OF CENTRAL FLORIDA LLC
Entity Type:Organization
Organization Name:MEDICAL CONSULTANT OF CENTRAL FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:DINO
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:SORIANO
Authorized Official - Suffix:SR
Authorized Official - Credentials:RN
Authorized Official - Phone:407-702-8095
Mailing Address - Street 1:PO BOX 953546
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32795-3546
Mailing Address - Country:US
Mailing Address - Phone:407-702-8095
Mailing Address - Fax:
Practice Address - Street 1:2798 AMAYA TER
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2390
Practice Address - Country:US
Practice Address - Phone:407-702-8095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-05
Last Update Date:2010-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier