Healthcare Provider Details

I. General information

NPI: 1376509521
Provider Name (Legal Business Name): PAULINO MILLA-ORELLANA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 E ALTAMONTE DRIVE STE 217
ALTAMONTE SPRINGS FL
32701
US

IV. Provider business mailing address

661 E ALTAMONTE DRIVE STE 217
ALTAMONTE SPRINGS FL
32701
US

V. Phone/Fax

Practice location:
  • Phone: 407-339-3030
  • Fax: 407-339-3003
Mailing address:
  • Phone: 407-339-3030
  • Fax: 407-339-3003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME0058262
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: