Healthcare Provider Details

I. General information

NPI: 1932178472
Provider Name (Legal Business Name): REBECCA JOANNE ADAMS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 CONCOURSE PKWY SOUTH SUITE 200
MAITLAND FL
32751
US

IV. Provider business mailing address

790 CONCOURSE PKWY SOUTH SUITE 200
MAITLAND FL
32751
US

V. Phone/Fax

Practice location:
  • Phone: 407-767-6411
  • Fax: 407-767-8160
Mailing address:
  • Phone: 407-767-6411
  • Fax: 407-767-8160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME110617
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License NumberME110617
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: