Healthcare Provider Details

I. General information

NPI: 1174560858
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: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

89 W COPELAND DR 2ND FLOOR
ORLANDO FL
32806-2028
US

IV. Provider business mailing address

89 W COPELAND DR 2ND FLOOR
ORLANDO FL
32806-2028
US

V. Phone/Fax

Practice location:
  • Phone: 407-237-6319
  • Fax: 407-843-8505
Mailing address:
  • Phone: 407-237-6319
  • Fax: 407-843-8505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

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