Healthcare Provider Details

I. General information

NPI: 1912444027
Provider Name (Legal Business Name): MEDSURG HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2017
Last Update Date: 01/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N ORANGE AVE SUITE 730
ORLANDO FL
32801-1026
US

IV. Provider business mailing address

801 N ORANGE AVE SUITE 730
ORLANDO FL
32801-1026
US

V. Phone/Fax

Practice location:
  • Phone: 407-343-7242
  • Fax: 844-273-9236
Mailing address:
  • Phone: 407-343-7242
  • Fax: 844-273-9236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER WALKER
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 407-434-7242