Healthcare Provider Details

I. General information

NPI: 1245031624
Provider Name (Legal Business Name): MILO J.E. OBAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 W OAK ST STE 201
KISSIMMEE FL
34741-4998
US

IV. Provider business mailing address

720 W OAK ST STE 201
KISSIMMEE FL
34741-4998
US

V. Phone/Fax

Practice location:
  • Phone: 407-518-2703
  • Fax:
Mailing address:
  • Phone: 407-518-2703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: