Healthcare Provider Details

I. General information

NPI: 1942974209
Provider Name (Legal Business Name): ORLANDO PHYSICIANS NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2021
Last Update Date: 08/02/2021
Certification Date: 08/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4750 THE GROVE DR STE 250
WINDERMERE FL
34786-8427
US

IV. Provider business mailing address

1414 KUHL AVE # MP38
ORLANDO FL
32806-2008
US

V. Phone/Fax

Practice location:
  • Phone: 407-354-0717
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELE NAPIER
Title or Position: VP, REVENUE MANAGEMENT
Credential:
Phone: 321-841-3492