Healthcare Provider Details

I. General information

NPI: 1174450290
Provider Name (Legal Business Name): AXYS HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 W FAIRBANKS AVE
WINTER PARK FL
32789-7111
US

IV. Provider business mailing address

1245 W FAIRBANKS AVE
WINTER PARK FL
32789-7111
US

V. Phone/Fax

Practice location:
  • Phone: 407-347-7052
  • Fax:
Mailing address:
  • Phone: 407-347-7052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HUMBERTO LIRIANO
Title or Position: CMO
Credential: MD
Phone: 407-848-9394