Healthcare Provider Details

I. General information

NPI: 1740627850
Provider Name (Legal Business Name): MS. ARLENE PATRICIA GRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2013
Last Update Date: 08/17/2025
Certification Date: 08/17/2025
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

2580 WENSINGER WAY APT 304
KISSIMMEE FL
34747-2635
US

V. Phone/Fax

Practice location:
  • Phone: 407-272-5088
  • Fax:
Mailing address:
  • Phone: 407-272-5088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License NumberCL0213592
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code224900000X
TaxonomyMastectomy Fitter
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: