Healthcare Provider Details

I. General information

NPI: 1033181433
Provider Name (Legal Business Name): TRAUMA PHYSICIANS SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 10/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE SUITE 340
ORLANDO FL
32804-4603
US

IV. Provider business mailing address

PO BOX 547304
ORLANDO FL
32854-7304
US

V. Phone/Fax

Practice location:
  • Phone: 407-895-3384
  • Fax: 407-895-3789
Mailing address:
  • Phone: 407-895-3384
  • Fax: 407-895-3789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE COLE
Title or Position: OWNER
Credential:
Phone: 407-895-3384