MEDICARE: MID-FLORIDA ENDODONTICS - DR. PHILLIPS, PLLC

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	1223E0200X	Endodontics

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255084059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MID-FLORIDA ENDODONTICS - DR. PHILLIPS, PLLC

Provider Business Mailing Address
First Line	:	7932 W SAND LAKE RD STE 304
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7230
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7932 W SAND LAKE RD STE 304
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-7230
Country	:	US
Telephone Number	:	407-581-9515
Fax Number	:

Authorized Official
Title or Position	:	INSURANCE COORDINATOR
Name	:	MRS. NATASHA UPADHYAY
Credential	:
Telephone Number	:	407-581-9515

Provider Enumeration Date	:	02/01/2022
Last Update Date	:	05/01/2025

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