Healthcare Provider Details
I. General information
NPI: 1376326082
Provider Name (Legal Business Name): ORLANDOPHYSICIANS PRACTICE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/16/2023
Last Update Date: 08/16/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2295 S. HIAWASSEE ROAD SUITE 210
ORLANDO FL
32835
US
IV. Provider business mailing address
2295 S. HIAWASSEE ROAD SUITE 210
ORLANDO FL
32835
US
V. Phone/Fax
- Phone: 718-924-3611
- Fax: 407-233-4010
- Phone: 718-924-3611
- Fax: 407-233-4010
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DANIEL
RSA
HAY
Title or Position: CO-OWNER/DIRECTOR
Credential: D.O.
Phone: 718-924-3611