Healthcare Provider Details

I. General information

NPI: 1043241235
Provider Name (Legal Business Name): LOU C HAROLD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1173 BLACKWOOD AVE
OCOEE FL
34761-4518
US

IV. Provider business mailing address

1173 BLACKWOOD AVE
OCOEE FL
34761-4518
US

V. Phone/Fax

Practice location:
  • Phone: 407-839-3700
  • Fax: 407-839-0640
Mailing address:
  • Phone: 407-839-3700
  • Fax: 407-839-0640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME47297
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME47297
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: