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General NPI Number Information
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NPI Number | 1477121309
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Entity Type | Organization
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Legal Business Name | ORLANDO FAMILY PHYSICIANS, LLC
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Dates
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Enumeration Date | 06/16/2021
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 790 BUENAVENTURA BLVD
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City | KISSIMMEE
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State | FL
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Zip | 34743-8128
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Country | US
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Telephone | 407-344-9959
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Fax | 407-344-9971
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Provider Business Mailing Address
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Address Line | 425 W COLONIAL DR STE 303
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City | ORLANDO
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State | FL
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Zip | 32804-6863
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Country | US
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Telephone | 321-332-6947
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Fax | 407-286-4515
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | PENELOPE KOKKINIDES
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Credential |
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Telephone | 201-270-7825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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