Healthcare Provider Details

I. General information

NPI: 1003017435
Provider Name (Legal Business Name): WEST ORANGE HEALTHCARE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 W COLONIAL DR STE 387
OCOEE FL
34761-3498
US

IV. Provider business mailing address

10000 W COLONIAL DR STE 387
OCOEE FL
34761-3498
US

V. Phone/Fax

Practice location:
  • Phone: 407-578-0033
  • Fax: 407-294-8003
Mailing address:
  • Phone: 407-578-0033
  • Fax: 407-294-8003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLOS MIQUEL DIEGUEZ
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 407-578-0033