Provider Demographics
NPI:1336581594
Name:LOS DOCTORS, LLC
Entity Type:Organization
Organization Name:LOS DOCTORS, LLC
Other - Org Name:LOS DOCTORS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:OSWALDO
Authorized Official - Middle Name:J
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RMHCI
Authorized Official - Phone:407-797-7298
Mailing Address - Street 1:100 S SEMORAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-3231
Mailing Address - Country:US
Mailing Address - Phone:407-797-7298
Mailing Address - Fax:407-277-7622
Practice Address - Street 1:100 S SEMORAN BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3231
Practice Address - Country:US
Practice Address - Phone:407-797-7298
Practice Address - Fax:407-277-7622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH13560101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1336581594Medicare UPIN