Healthcare Provider Details
I. General information
NPI: 1659944114
Provider Name (Legal Business Name): ORLANDO HEALTH MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2021
Last Update Date: 07/22/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7236 STONEROCK CIR
ORLANDO FL
32819-8000
US
IV. Provider business mailing address
1414 KUHL AVE # MP38
ORLANDO FL
32806-2008
US
V. Phone/Fax
- Phone: 321-841-6444
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHELE
T.
NAPIER
Title or Position: VP, REVENUE MANAGEMENT
Credential:
Phone: 321-841-3492