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General NPI Number Information
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NPI Number | 1245241546
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Entity Type | Organization
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Legal Business Name | FETAL DIAGNOSTIC CENTER OF ORLANDO, INC.
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 05/27/2009
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Provider Practice Location Address
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Address Line | 615 E PRINCETON ST SUITE 240
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City | ORLANDO
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State | FL
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Zip | 32803-1456
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Country | US
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Telephone | 407-897-3737
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Fax | 407-897-3711
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Provider Business Mailing Address
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Address Line | 615 E PRINCETON ST SUITE 240
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City | ORLANDO
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State | FL
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Zip | 32803-1456
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Country | US
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Telephone | 407-897-3737
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Fax | 407-897-3711
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | LORI HASKINS
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Credential |
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Telephone | 407-897-3737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number |
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License Number State |
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