Healthcare Provider Details

I. General information

NPI: 1801000526
Provider Name (Legal Business Name): IORDANCA DANIELA ANICA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 11/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 W GORE ST 5TH FLOOR
ORLANDO FL
32806-1134
US

IV. Provider business mailing address

32 W GORE ST 5TH FLOOR
ORLANDO FL
32806-1134
US

V. Phone/Fax

Practice location:
  • Phone: 407-649-6151
  • Fax: 407-843-6658
Mailing address:
  • Phone: 407-649-6151
  • Fax: 407-843-6658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number31377
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberME105632
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: