Healthcare Provider Details

I. General information

NPI: 1134595093
Provider Name (Legal Business Name): ARTHRITIS CENTER OF ORLANDO PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2015
Last Update Date: 11/17/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 CITRUS MEDICAL CT
OCOEE FL
34761
US

IV. Provider business mailing address

PO BOX 645
GOTHA FL
34734-0645
US

V. Phone/Fax

Practice location:
  • Phone: 407-757-0277
  • Fax: 407-757-0271
Mailing address:
  • Phone: 407-296-1540
  • Fax: 407-296-2549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberME114449
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: DR. NIMESH A DAYAL
Title or Position: OWNER
Credential: MD
Phone: 407-757-0277