Healthcare Provider Details

I. General information

NPI: 1538148762
Provider Name (Legal Business Name): FRANK ORLA AXELSEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 W HIGHWAY 98
PENSACOLA FL
32512-1006
US

IV. Provider business mailing address

6000 W HIGHWAY 98
PENSACOLA FL
32512-1239
US

V. Phone/Fax

Practice location:
  • Phone: 850-505-6611
  • Fax:
Mailing address:
  • Phone: 850-505-6611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberME141359
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101266057
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License NumberME141359
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: