W Sand Lake Medical Group LLC

NPI #1558726257 in Orlando, Florida

Provider Information

NPI Number: 1558726257
Entity Type: Organization
Organization Name: W Sand Lake Medical Group LLC
Primary Specialty: Internal Medicine - Addiction Medicine
Enumeration Date: Dec 22, 2015
Last Updated: Dec 22, 2015

Practice Location

Address: 2431 SAND LAKE RD
City: Orlando
State: Florida
ZIP Code: 32809-7641
Phone: (855) 876-8648

Authorized Official

Name: NICK MATTEO
Title: CFO
Phone: (561) 318-4430

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine - Addiction Medicine — Addiction Medicine	207RA0401X	Primary

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