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NPI Code Detail

MEDICARE: ORLANDO PHYSICIAN SPECIALISTS LLC

MEDICARE: ORLANDO PHYSICIAN SPECIALISTS LLC
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
1207RH0003XHematology & Oncology Physician

General Provider Information

NPI Number : 1144773706
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORLANDO PHYSICIAN SPECIALISTS LLC
Provider Business Mailing Address
First Line : 1561 W FAIRBANKS AVE
Second Line : SUITE 100
City : WINTER PARK
State : FL
Zip : 32789-4678
Country : US
Telephone Number : 407-478-4920
Fax Number :
Provider Business Practice Location Address
First Line : 830 29TH ST
Second Line :
City : ORLANDO
State : FL
Zip : 32805-6219
Country : US
Telephone Number : 407-843-3230
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : CHARLES WITTEN
Credential : MD
Telephone Number : 214-648-5413
Provider Enumeration Date : 08/01/2016
Last Update Date : 08/01/2016

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Directions to “ORLANDO PHYSICIAN SPECIALISTS LLC ” Practice Location

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