Healthcare Provider Details

I. General information

NPI: 1639354467
Provider Name (Legal Business Name): AMRA GAVRIC MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMRA ARSLANAGIC

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 PARK CENTER DR STE 6B
ORLANDO FL
32835-5700
US

IV. Provider business mailing address

1651 N SEMORAN BLVD
ORLANDO FL
32807-3575
US

V. Phone/Fax

Practice location:
  • Phone: 407-249-1234
  • Fax: 407-249-1755
Mailing address:
  • Phone: 407-249-1234
  • Fax: 407-249-1755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME98141
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: