Healthcare Provider Details

I. General information

NPI: 1700926615
Provider Name (Legal Business Name): EMMANUEL N SAINTFLEUR PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE SUITE 340
ORLANDO FL
32804-4603
US

IV. Provider business mailing address

2501 N ORANGE AVE SUITE 340
ORLANDO FL
32804-4603
US

V. Phone/Fax

Practice location:
  • Phone: 407-895-8890
  • Fax: 407-895-3608
Mailing address:
  • Phone: 407-895-8890
  • Fax: 407-895-3608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9101877
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: