MEDICARE: DR. ERIC ORDINARIO D.O.

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	208800000X	Urology Physician	OS7652	FL

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	:	1871545301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC ORDINARIO D.O.

Provider Business Mailing Address
First Line	:	4601 W US HIGHWAY 90
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32055-4880
Country	:	US
Telephone Number	:	386-752-4189
Fax Number	:	386-752-4213

Provider Business Practice Location Address
First Line	:	4601 W US HIGHWAY 90
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32055-4880
Country	:	US
Telephone Number	:	386-752-4189
Fax Number	:	386-752-4213

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	11/09/2023

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Directions to “ DR. ERIC ORDINARIO D.O.” Practice Location

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