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General NPI Number Information
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NPI Number | 1457350191
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Entity Type | Individual
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Provider Name | CRAIG M. MINTZER M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 8701 MAITLAND SUMMIT BLVD
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City | ORLANDO
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State | FL
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Zip | 32810-5915
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Country | US
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Telephone | 407-916-4120
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Fax | 407-643-2806
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Provider Business Mailing Address
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Address Line | 8701 MAITLAND SUMMIT BLVD
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City | ORLANDO
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State | FL
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Zip | 32810-5915
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Country | US
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Telephone | 407-916-4120
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Fax | 407-643-2806
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME0069915
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | ME0069915
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | ME0069915
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | ME69915
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License Number State | FL
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