Healthcare Provider Details

I. General information

NPI: 1235213331
Provider Name (Legal Business Name): MICHAEL ORRIS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-8202
US

IV. Provider business mailing address

9854 NW 18TH ST
PEMBROKE PINES FL
33024-1445
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-5911
  • Fax:
Mailing address:
  • Phone: 561-422-7577
  • Fax: 561-422-7615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS9494
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: