| NAME |
ZZ-WINTER PARK VA OOS |
| STATE |
FLORIDA |
| STREET ADDR. 1 |
925 SOUTH SEMORAN BLVD, #112, 114, 120 |
| CITY |
WINTER PARK |
| ZIP |
32792-5313 |
| OFFICIAL VA NAME |
CROSSROADS VA CLINIC |
| INACTIVE FACILITY FLAG |
INACTIVE |
| STATUS |
National |
| ASSOCIATIONS |
|
| BILLING FACILITY NAME |
WINTER PARK VA OOS |
| EFFECTIVE DATE/TIME |
-
- 2014-10-01 00:00:00
- STATUS: ACTIVE
- NPI: 1407244775
-
- 2023-02-08 00:00:00
- STATUS: INACTIVE
- NPI: 1407244775
|
| TAXONOMY CODE |
|
| LOCATION TIMEZONE |
EASTERN |
| COUNTRY |
USA |
| STATION NUMBER |
675QD |
| IDENTIFIER |
-
- CODING SYSTEM: CLIA
- ID: 10D2006449
|
