Healthcare Provider Details

I. General information

NPI: 1528358116
Provider Name (Legal Business Name): ORLANDO HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2011
Last Update Date: 07/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 W MILLER ST # MP374
ORLANDO FL
32806-2032
US

IV. Provider business mailing address

1414 KUHL AVE STE MP-10 SUITE MP-10
ORLANDO FL
32806-2008
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-1648
  • Fax: 321-841-9102
Mailing address:
  • Phone: 321-841-1648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPH25381
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ROXANNE BLANCHARD
Title or Position: CORPORATE MANAGER, RETAIL PHARMACY
Credential: RPH
Phone: 321-843-8535