Healthcare Provider Details

I. General information

NPI: 1669419370
Provider Name (Legal Business Name): ORLANDO HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 10/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 W COPELAND DR 1ST FLOOR
ORLANDO FL
32806-2028
US

IV. Provider business mailing address

89 W COPELAND DR 1ST FLOOR
ORLANDO FL
32806-2028
US

V. Phone/Fax

Practice location:
  • Phone: 407-841-5281
  • Fax: 407-648-9879
Mailing address:
  • Phone: 407-841-5281
  • Fax: 407-648-9879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: KEITH EGGERT
Title or Position: VP REVENUE MANAGEMENT
Credential:
Phone: 407-237-6393