Healthcare Provider Details

I. General information

NPI: 1215475504
Provider Name (Legal Business Name): ORLANDO PLASTIC SURGERY INSTITUTE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2017
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N ORANGE AVE SUITE 530
ORLANDO FL
32801-1026
US

IV. Provider business mailing address

801 N ORANGE AVE SUITE 530
ORLANDO FL
32801-1026
US

V. Phone/Fax

Practice location:
  • Phone: 407-845-8280
  • Fax:
Mailing address:
  • Phone: 407-845-8280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: ANUP PATEL
Title or Position: PLASTIC SURGEON
Credential: MD
Phone: 407-845-8280