Healthcare Provider Details

I. General information

NPI: 1376560284
Provider Name (Legal Business Name): LOUISE DIANE FERLAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 12/04/2023
Certification Date: 12/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 W GORE ST
ORLANDO FL
32806-1113
US

IV. Provider business mailing address

55 W GORE ST
ORLANDO FL
32806-1113
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-5469
  • Fax: 321-841-7470
Mailing address:
  • Phone: 321-841-5469
  • Fax: 321-841-7470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License NumberME145374
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberME145374
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberME145374
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: