Healthcare Provider Details
I. General information
NPI: 1144993072
Provider Name (Legal Business Name): ORLANDO HEALTH MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2021
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10000 W COLONIAL DR
OCOEE FL
34761-3400
US
IV. Provider business mailing address
1414 KUHL AVE # MP38
ORLANDO FL
32806-2008
US
V. Phone/Fax
- Phone: 407-296-1873
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VF0040X |
| Taxonomy | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHELE
NAPIER
Title or Position: VP, REVENUE MANAGEMENT
Credential:
Phone: 321-841-3492