Healthcare Provider Details

I. General information

NPI: 1184480196
Provider Name (Legal Business Name): OHRI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2024
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 W BROADWAY ST
OVIEDO FL
32765-6577
US

IV. Provider business mailing address

1414 KUHL AVE # MP212
ORLANDO FL
32806-2008
US

V. Phone/Fax

Practice location:
  • Phone: 407-331-9355
  • Fax:
Mailing address:
  • Phone: 407-331-9355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YESENIA GOMEZ MOSHER
Title or Position: SR. DIRECTOR
Credential:
Phone: 321-842-3777