Basic Information
| Provider Information | |||||||||
| NPI: | 1972226249 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OHRI, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1414 KUHL AVENUE | ||||||||
| Address2: | MP 212 | ||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073319355 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1210 E OSCEOLA PKWY STE 1-4 | ||||||||
| Address2: | |||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347441621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073319355 | ||||||||
| FaxNumber: | 4073319481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2022 | ||||||||
| LastUpdateDate: | 09/22/2022 | ||||||||
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| AuthorizedOfficialLastName: | MOSHER | ||||||||
| AuthorizedOfficialFirstName: | YESENIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | SR. DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3218423777 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| NPICertificationDate: | 09/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Radiology |
No ID Information.