Healthcare Provider Details

I. General information

NPI: 1750410817
Provider Name (Legal Business Name): GARY G LEHMAN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2881 S BUMBY AVE
ORLANDO FL
32806-8704
US

IV. Provider business mailing address

2881 S BUMBY AVE
ORLANDO FL
32806-8704
US

V. Phone/Fax

Practice location:
  • Phone: 407-894-0005
  • Fax: 407-894-7759
Mailing address:
  • Phone: 407-894-0005
  • Fax: 407-894-7759

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberME41509
License Number StateFL

VIII. Authorized Official

Name: DR. GARY GRAYSON LEHMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 407-894-0005