Healthcare Provider Details

I. General information

NPI: 1073873931
Provider Name (Legal Business Name): DAVID ANDREW OSSIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2012
Last Update Date: 08/10/2023
Certification Date: 08/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3438 LAWTON RD STE 2D
ORLANDO FL
32803-2948
US

IV. Provider business mailing address

3438 LAWTON RD STE 2D
ORLANDO FL
32803-2948
US

V. Phone/Fax

Practice location:
  • Phone: 407-751-2868
  • Fax: 407-868-8498
Mailing address:
  • Phone: 407-751-2868
  • Fax: 407-868-8498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME129895
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: