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General NPI Number Information
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NPI Number | 1407276157
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Entity Type | Individual
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Provider Name | DR. MARY K. REISCHMANN
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Gender | Female
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Dates
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Enumeration Date | 04/21/2014
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 1222 S ORANGE AVE
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City | ORLANDO
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State | FL
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Zip | 32806-1215
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Country | US
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Telephone | 321-841-7856
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Fax | 321-843-6432
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Provider Business Mailing Address
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Address Line | PO BOX 919741
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City | ORLANDO
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State | FL
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Zip | 32891-9741
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Country | US
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Telephone | 321-841-8491
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Fax | 321-843-6075
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | ME144140
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME144140
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License Number State | FL
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