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General NPI Number Information
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NPI Number | 1740268929
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Entity Type | Organization
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Legal Business Name | WINTER PARK FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 541 S ORLANDO AVE STE 204
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City | MAITLAND
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State | FL
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Zip | 32751-5669
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Country | US
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Telephone | 407-647-4008
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Fax | 407-647-3207
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Provider Business Mailing Address
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Address Line | 541 S ORLANDO AVE STE 204
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City | MAITLAND
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State | FL
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Zip | 32751-5669
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Country | US
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Telephone | 407-647-4008
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Fax | 407-647-3207
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Authorized Official
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Title or Position | OWNER
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Name | VARESH R PATEL
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Credential | DO
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Telephone | 407-647-4008
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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 | FL
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