Provider Demographics
NPI:1891730206
Name:ORIENTAL MEDICAL CLINIC OF FLORIDA
Entity Type:Organization
Organization Name:ORIENTAL MEDICAL CLINIC OF FLORIDA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANIE
Authorized Official - Middle Name:O
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM
Authorized Official - Phone:863-386-5050
Mailing Address - Street 1:3101 MEDICAL WAY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5548
Mailing Address - Country:US
Mailing Address - Phone:863-386-5050
Mailing Address - Fax:863-402-1090
Practice Address - Street 1:3101 MEDICAL WAY
Practice Address - Street 2:SUITE 2
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5548
Practice Address - Country:US
Practice Address - Phone:863-386-5050
Practice Address - Fax:863-402-1090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty