Healthcare Provider Details

I. General information

NPI: 1710928759
Provider Name (Legal Business Name): JOSEPH A. PAOLILLO JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE STE 310
ORLANDO FL
32804-4642
US

IV. Provider business mailing address

2501 N ORANGE AVE STE 310
ORLANDO FL
32804-4642
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-2001
  • Fax:
Mailing address:
  • Phone: 407-303-2001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2010-00964
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number2010-00964
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberME90375
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number84119
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: