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General NPI Number Information
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NPI Number | 1558774224
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Entity Type | Organization
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Legal Business Name | UF CANCER CENTER AT ORLANDO HEALTH
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | 1414 KUHL AVE MP 710
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City | ORLANDO
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State | FL
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Zip | 32806-2008
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Country | US
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Telephone | 321-841-6947
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 S ORANGE AVE
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City | ORLANDO
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State | FL
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Zip | 32806-2134
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Country | US
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Telephone | 321-841-1869
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Fax |
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Authorized Official
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Title or Position | PRACTICE OPERATIONS MANAGER
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Name | MELISSA WOJTECZKO
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Credential |
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Telephone | 321-841-1869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PAT9107947
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License Number State | FL
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