Healthcare Provider Details

I. General information

NPI: 1447480975
Provider Name (Legal Business Name): ROBERT HUNG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2009
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4151 HUNTERS PARK LN STE 132
ORLANDO FL
32837-3617
US

IV. Provider business mailing address

6675 WESTWOOD BLVD SUITE 475
ORLANDO FL
32821-8061
US

V. Phone/Fax

Practice location:
  • Phone: 407-530-4802
  • Fax: 407-574-3260
Mailing address:
  • Phone: 407-845-0330
  • Fax: 888-972-1752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME122383
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: