Healthcare Provider Details

I. General information

NPI: 1982628566
Provider Name (Legal Business Name): ROBERT J ESTRADA DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 PARK CENTER DR STE 210
ORLANDO FL
32835-6216
US

IV. Provider business mailing address

1803 PARK CENTER DR STE 210
ORLANDO FL
32835-6216
US

V. Phone/Fax

Practice location:
  • Phone: 407-299-1335
  • Fax: 407-299-1835
Mailing address:
  • Phone: 407-299-1335
  • Fax: 407-299-1835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberPO 2092
License Number StateFL

VIII. Authorized Official

Name: DR. ROBERT J ESTRADA
Title or Position: PRESIDENT
Credential: DPM
Phone: 407-299-1335