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General NPI Number Information
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NPI Number | 1720449580
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Entity Type | Organization
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Legal Business Name | ORLANDO REGIONAL MED CTR
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Dates
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Enumeration Date | 03/08/2016
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Last Update Date | 03/08/2016
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Provider Practice Location Address
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Address Line | 1414 KUHL AVE MP 180
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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 | 321-841-2450
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Fax |
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Provider Business Mailing Address
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Address Line | 1414 KUHL AVE MP 180
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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 | 321-841-2450
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Fax |
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Authorized Official
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Title or Position | PHARMACYMANAGER
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Name | MR. WILLIAM J WILSON
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Credential | RPH
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Telephone | 321-841-2450
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | PH6697
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License Number State | FL
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