MEDICARE: MARK ALLEN ORLANDO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	019633	GA

General Provider Information

NPI Number	:	1861739799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK ALLEN ORLANDO

Provider Business Mailing Address
First Line	:	102 TOPAZ DR
Second Line	:
City	:	DALLAS
State	:	GA
Zip	:	30132-9457
Country	:	US
Telephone Number	:	404-848-0336
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 PEACHTREE RD NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-4915
Country	:	US
Telephone Number	:	404-848-0336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2013
Last Update Date	:	01/11/2013

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Directions to “ MARK ALLEN ORLANDO ” Practice Location

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