Healthcare Provider Details

I. General information

NPI: 1386183705
Provider Name (Legal Business Name): XAVIER ATENCIO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2017
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7727 LAKE UNDERHILL RD
ORLANDO FL
32822-8224
US

IV. Provider business mailing address

7727 LAKE UNDERHILL RD
ORLANDO FL
32822-8224
US

V. Phone/Fax

Practice location:
  • Phone: 407-821-3508
  • Fax:
Mailing address:
  • Phone: 407-821-3508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME149889
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.138795
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.138795
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME149889
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: