MEDICARE: ORLANDO VAMC

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	261QV0200X	VA Clinic/Center

General Provider Information

NPI Number	:	1831719715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORLANDO VAMC

Provider Business Mailing Address
First Line	:	PO BOX 94471
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44101-4471
Country	:	US
Telephone Number	:	866-793-4591
Fax Number	:

Provider Business Practice Location Address
First Line	:	5200 BABCOCK ST NE STE 101
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-4639
Country	:	US
Telephone Number	:	866-793-4591
Fax Number	:

Authorized Official
Title or Position	:	NPI TEAM
Name	:	ERIN DENISE POTTER
Credential	:
Telephone Number	:	202-382-2579

Provider Enumeration Date	:	04/21/2020
Last Update Date	:	03/28/2023

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Directions to “ORLANDO VAMC ” Practice Location

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