Basic Information
| Provider Information | |||||||||
| NPI: | 1417518481 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OHRI, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1414 KUHL AVE MP 162 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3218418779 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5151 WINTER GARDEN VINELAND ROAD., SUITE 104 | ||||||||
| Address2: | |||||||||
| City: | WINDERMERE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076378356 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2019 | ||||||||
| LastUpdateDate: | 10/04/2021 | ||||||||
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| AuthorizedOfficialLastName: | HORNERBRINK | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | CORPORATE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3218418779 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.