MEDICARE: ORLANDO FAMILY MEDICAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1023119641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORLANDO FAMILY MEDICAL INC

Provider Business Mailing Address
First Line	:	931 W OAK ST
Second Line	:	STE 103
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-4973
Country	:	US
Telephone Number	:	407-931-0444
Fax Number	:	407-962-4446

Provider Business Practice Location Address
First Line	:	931 W OAK ST STE 103
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34741-4973
Country	:	US
Telephone Number	:	407-931-0444
Fax Number	:	407-962-4446

Authorized Official
Title or Position	:	PRES
Name	:	JUAN J GARCIA
Credential	:
Telephone Number	:	407-922-4839

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	11/21/2024

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