Healthcare Provider Details

I. General information

NPI: 1366046450
Provider Name (Legal Business Name): ORLANDO HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 6TH ST S
ST PETERSBURG FL
33701-4814
US

IV. Provider business mailing address

1111 BLACKWOOD AVE
OCOEE FL
34761-4549
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-8535
  • Fax:
Mailing address:
  • Phone: 321-843-8535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOHN ENOCH MILLER
Title or Position: VP FINANCE
Credential:
Phone: 321-843-3180