MEDICARE: ORLANDO HEALTH MEDICAL GROUP 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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1578236402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORLANDO HEALTH MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	1414 KUHL AVE # MP38
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-2008
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1135 E STATE ROAD 434
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-2746
Country	:	US
Telephone Number	:	407-636-7841
Fax Number	:

Authorized Official
Title or Position	:	VP, REVENUE MANAGEMENT
Name	:	MICHELE NAPIER
Credential	:
Telephone Number	:	321-841-3492

Provider Enumeration Date	:	07/27/2021
Last Update Date	:	07/27/2021

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