Healthcare Provider Details

I. General information

NPI: 1619892437
Provider Name (Legal Business Name): MILINDU CHANAKA MAKANDURA MD, FRCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5979 VINELAND RD STE 101
ORLANDO FL
32819-7860
US

IV. Provider business mailing address

5905 CARAVAN CT APT 3109
ORLANDO FL
32819-7983
US

V. Phone/Fax

Practice location:
  • Phone: 407-355-3120
  • Fax:
Mailing address:
  • Phone: 407-355-3120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberME183795
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: