Healthcare Provider Details

I. General information

NPI: 1457982142
Provider Name (Legal Business Name): THE UNIVERSITY OF CENTRAL FLORIDA BOARD OF TRUSTEES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2020
Last Update Date: 05/26/2021
Certification Date: 05/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 PROGRESS DRIVE
ORLANDO FL
32826-2903
US

IV. Provider business mailing address

6850 LAKE NONA BOULEVARD, 3RD FLOOR LEGAL AFFAIRS
ORLANDO FL
32827-7408
US

V. Phone/Fax

Practice location:
  • Phone: 407-882-0468
  • Fax: 407-882-0483
Mailing address:
  • Phone: 407-882-0468
  • Fax: 407-882-0483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: DR. DEBORAH C. GERMAN
Title or Position: VICE PRESIDENT FOR HEALTH AFFAIRS
Credential: MD
Phone: 407-266-1000