| NAME |
KISSIMMEE VA CLINIC |
| STATE |
FLORIDA |
| STREET ADDR. 1 |
701 UNION ST |
| CITY |
KISSIMMEE |
| ZIP |
34741-5007 |
| OFFICIAL VA NAME |
KISSIMMEE VA CLINIC |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
KISSIMMEE VA CLINIC |
| ST. ADDR. 1 (MAILING) |
2285 NORTH CENTRAL AVENUE |
| CITY (MAILING) |
KISSIMMEE |
| STATE (MAILING) |
FLORIDA |
| ZIP (MAILING) |
34741-2342 |
| EFFECTIVE DATE/TIME |
-
- 2009-10-01 00:00:00
- STATUS: ACTIVE
- NPI: 1750614715
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| AGENCY CODE |
VA |
| POINTER TO AGENCY |
VA |
| STATION NUMBER |
675GC |
| IDENTIFIER |
-
- CODING SYSTEM: VASTANUM
- ID: 675GC
|
