Healthcare Provider Details

I. General information

NPI: 1205894136
Provider Name (Legal Business Name): MLB ORLANDO, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 S ORANGE AVE #117
ORLANDO FL
32806-6946
US

IV. Provider business mailing address

4401 S ORANGE AVE #117
ORLANDO FL
32806-6946
US

V. Phone/Fax

Practice location:
  • Phone: 407-856-0110
  • Fax: 407-850-9645
Mailing address:
  • Phone: 407-856-0110
  • Fax: 407-850-9645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN V MURRAY
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 407-856-0110