Basic Information
| Provider Information | |||||||||
| NPI: | 1295308682 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORLANDO HEALTH MEDICAL GROUP INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1414 KUHL AVE # MP38 | ||||||||
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| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328062008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3218424713 | ||||||||
| FaxNumber: | 3218430585 | ||||||||
| Practice Location | |||||||||
| Address1: | 1890 W COUNTY ROAD 419 | ||||||||
| Address2: | |||||||||
| City: | OVIEDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327654402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076353340 | ||||||||
| FaxNumber: | 3218421269 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2021 | ||||||||
| LastUpdateDate: | 07/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | NAPIER | ||||||||
| AuthorizedOfficialFirstName: | MICHELE | ||||||||
| AuthorizedOfficialMiddleName: | T. | ||||||||
| AuthorizedOfficialTitleorPosition: | VP, REVENUE MANAGEMENT | ||||||||
| AuthorizedOfficialTelephone: | 3218413492 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 07/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0216X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Rheumatology |
No ID Information.