Healthcare Provider Details

I. General information

NPI: 1598087231
Provider Name (Legal Business Name): WOMEN'S HEALTHCARE OF ORLANDO, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 11/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 AVALON PARK WEST BLVD SUITE 230
ORLANDO FL
32828-7303
US

IV. Provider business mailing address

PO BOX 781444
ORLANDO FL
32878-1444
US

V. Phone/Fax

Practice location:
  • Phone: 407-453-2072
  • Fax:
Mailing address:
  • Phone: 407-453-2072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberME 104799
License Number StateFL

VIII. Authorized Official

Name: DR. INGRID PATRICIA DUNN
Title or Position: SOLO PRACTITIONER
Credential: M.D.
Phone: 407-453-2072