Healthcare Provider Details

I. General information

NPI: 1902543291
Provider Name (Legal Business Name): ARLENE GRAY ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 08/30/2025
Certification Date: 08/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E ROBINSON ST STE 1120
ORLANDO FL
32801-1962
US

IV. Provider business mailing address

200 E ROBINSON ST STE 1120
ORLANDO FL
32801-1962
US

V. Phone/Fax

Practice location:
  • Phone: 407-839-6215
  • Fax: 407-839-6216
Mailing address:
  • Phone: 407-839-6215
  • Fax: 407-839-6216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. ARLENE PATRICIA GRAY
Title or Position: MANAGING DIRECTOR
Credential: HAIR LOSS SPECIALIST
Phone: 407-272-5088