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General NPI Number Information
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NPI Number | 1558912006
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Entity Type | Organization
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Legal Business Name | ORK MEDICAL
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Dates
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Enumeration Date | 09/26/2019
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Last Update Date | 02/11/2020
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Provider Practice Location Address
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Address Line | 2441 SOUTH HIAWASSEE ROAD
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City | ORLANDO
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State | FL
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Zip | 32835
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Country | US
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Telephone | 407-999-6383
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Fax |
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Provider Business Mailing Address
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Address Line | 12472 LAKE UNDERHILL RD # 162
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City | ORLANDO
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State | FL
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Zip | 32828-7144
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Country | US
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Telephone | 407-999-6383
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DALIEUN ORK JAIRAM
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Credential | APRN
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Telephone | 850-272-4479
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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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