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General NPI Number Information
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NPI Number | 1740804566
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Entity Type | Organization
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Legal Business Name | OURHEALTH PROFESSIONAL PHYSICIAN GROUP, LLC
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 501 W CHURCH ST
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City | ORLANDO
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State | FL
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Zip | 32805-2247
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Country | US
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Telephone | 689-210-0525
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1433
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City | PORTSMOUTH
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State | NH
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Zip | 03802-1433
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TERRY LAYMAN
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Credential | MD
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Telephone | 317-522-0844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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