Healthcare Provider Details

I. General information

NPI: 1912975426
Provider Name (Legal Business Name): ANNA ORMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 3RD ST
NEPTUNE BEACH FL
32266-5072
US

IV. Provider business mailing address

PO BOX 746636
ATLANTA GA
30374-6636
US

V. Phone/Fax

Practice location:
  • Phone: 904-202-4243
  • Fax: 904-202-4639
Mailing address:
  • Phone: 904-202-1032
  • Fax: 904-376-4107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME84129
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: