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General NPI Number Information
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NPI Number | 1205945763
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Entity Type | Organization
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Legal Business Name | MANOOGIAN ORTHOPEDIC CENTER, P.A.
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 1945 BAY RD
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City | MOUNT DORA
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State | FL
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Zip | 32757
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Country | US
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Telephone | 352-483-5633
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Fax | 352-483-5070
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Provider Business Mailing Address
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Address Line | 1945 BAY RD
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City | MOUNT DORA
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State | FL
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Zip | 32757-2105
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Country | US
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Telephone | 352-483-5633
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Fax | 352-483-5070
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VREJ K MANOOGIAN
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Credential | D.O.
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Telephone | 352-483-5633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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