Basic Information
Provider Information
NPI: 1871988154
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DEONARINE
FirstName: USHA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 601 E ROLLINS ST
Address2:  
City: ORLANDO
State: FL
PostalCode: 328031248
CountryCode: US
TelephoneNumber: 4073037283
FaxNumber: 4073030347
Practice Location
Address1: 601 E ROLLINS ST
Address2:  
City: ORLANDO
State: FL
PostalCode: 328031248
CountryCode: US
TelephoneNumber: 4073037283
FaxNumber: 4073030347
Other Information
ProviderEnumerationDate: 04/02/2015
LastUpdateDate: 01/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/19/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200XME147355FLY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


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