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General NPI Number Information
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NPI Number | 1447684170
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Entity Type | Organization
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Legal Business Name | ORANGE COUNTY CORRECTIONS
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Dates
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Enumeration Date | 08/29/2013
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Last Update Date | 08/29/2013
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Provider Practice Location Address
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Address Line | 2450 33RD ST
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City | ORLANDO
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State | FL
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Zip | 32839-8726
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Country | US
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Telephone | 407-254-7561
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Fax | 407-254-8284
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Provider Business Mailing Address
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Address Line | 2350 33RD STREET
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City | ORLANDO
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State | FL
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Zip | 32829
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Country | US
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Telephone | 407-254-7561
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Fax | 407-254-8284
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ROBERT J BUCK
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Credential | DO
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Telephone | 321-217-7950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | PA-9100248
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License Number State | FL
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