Healthcare Provider Details

I. General information

NPI: 1750291142
Provider Name (Legal Business Name): ANDREW O'CONNOR
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E ROLLINS ST
ORLANDO FL
32803-1248
US

IV. Provider business mailing address

1151 POST LAKE PL APT 307
APOPKA FL
32703-2914
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-5600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9661713
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: