Healthcare Provider Details

I. General information

NPI: 1881261030
Provider Name (Legal Business Name): ARVIN ESGANDANIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 LEE RD STE 200
ORLANDO FL
32810-5561
US

IV. Provider business mailing address

904 LEE RD STE 200
ORLANDO FL
32810-5561
US

V. Phone/Fax

Practice location:
  • Phone: 407-732-7373
  • Fax: 407-723-4842
Mailing address:
  • Phone: 407-732-7373
  • Fax: 407-723-4842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME163781
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: