Tabula Rasa Renewed

NPI 1215279534 - Counselor - 101Y00000X

NPI Details
NPI 1215279534
Enumeration Date 03/25/2013
Last Updated 03/25/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name CORDETT D CORDETT
Position PRESIDENT
Phone (407) 272-3700
Fax
Practice Location
702 PARK LAKE ST
ORLANDO FL, 32803-4024, US
Phone (407) 272-3700
Fax
Business Location
702 PARK LAKE ST
ORLANDO FL, 32803-4024, US
Phone
Fax
Toxanomy
Taxonomy Code 101Y00000X
License State
License Number
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According to our database, Tabula Rasa Renewed NPI is 1215279534, taxonomy code is 101Y00000X Tabula Rasa Renewed physically located at 702 Park Lake St, Orlando FL, 32803-4024. NPI Number 1033115704 has the healthcare provider type.

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1215279534 NPI number is provided on an as is basis without warranty of any kind. 1215279534 is maintained by the National Plan & Provider Enumeration System. The contents of Tabula Rasa Renewed are for informational purposes only.