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General NPI Number Information
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NPI Number | 1497100820
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Entity Type | Individual
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Provider Name | ANTONIO IMBARLINA JR. D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 100 W GORE ST
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City | ORLANDO
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State | FL
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Zip | 32806-1044
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Country | US
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Telephone | 321-842-6671
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Fax | 321-843-6521
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Provider Business Mailing Address
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Address Line | 100 W GORE ST
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City | ORLANDO
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State | FL
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Zip | 32806-1044
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Country | US
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Telephone | 321-842-6671
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Fax | 321-843-6521
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | OS022094
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number | OS21559
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License Number State | FL
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