Healthcare Provider Details

I. General information

NPI: 1447816889
Provider Name (Legal Business Name): ENRIQUE MURILLO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2019
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E ROBINSON ST STE 425
ORLANDO FL
32801-4347
US

IV. Provider business mailing address

200 E ROBINSON ST STE 425
ORLANDO FL
32801-4347
US

V. Phone/Fax

Practice location:
  • Phone: 833-769-3524
  • Fax:
Mailing address:
  • Phone: 833-769-3524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberBP10069152
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME161134
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: