Provider Demographics
NPI:1366139479
Name:ADDMEDHEALTH LLC
Entity type:Organization
Organization Name:ADDMEDHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/MGR
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:IRAN
Authorized Official - Last Name:LOPEZ BERMUDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-317-6199
Mailing Address - Street 1:1621 KERSLEY CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-1925
Mailing Address - Country:US
Mailing Address - Phone:321-317-6199
Mailing Address - Fax:
Practice Address - Street 1:12301 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4508
Practice Address - Country:US
Practice Address - Phone:689-248-6634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-19
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty