Healthcare Provider Details
I. General information
NPI: 1366648636
Provider Name (Legal Business Name): HEALTH. ORLANDO, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2007
Last Update Date: 06/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 PALM SPRINGS DR
ALTAMONTE SPRINGS FL
32701
US
IV. Provider business mailing address
PO BOX 162837
ALTAMONTE SPRINGS FL
32716
US
V. Phone/Fax
- Phone: 309-303-0355
- Fax:
- Phone: 309-692-0400
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 18005065 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 18005065 |
| License Number State | IL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 036096817 |
| License Number State | IL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 209005204 |
| License Number State | IL |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 209002447 |
| License Number State | IL |
VIII. Authorized Official
Name:
ANITA
SABHARWAL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 309-303-0355