Healthcare Provider Details

I. General information

NPI: 1508827676
Provider Name (Legal Business Name): BIRDIE VARNEDORE MD, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 01/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2823 NORTHAMPTON AVE
ORLANDO FL
32828-7912
US

IV. Provider business mailing address

2823 NORTHAMPTON AVE
ORLANDO FL
32828-7912
US

V. Phone/Fax

Practice location:
  • Phone: 407-754-6490
  • Fax: 407-512-4050
Mailing address:
  • Phone: 407-754-6490
  • Fax: 407-512-4050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: BIRDIE VARNEDORE
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 407-754-6490