| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1689972192 | FORMAN | MICAH | J | 807 S ORLANDO AVE | WINTER PARK | FL | 327894870 | |
| 1740460930 | KELSEY | JENNIFER | M | 807 S ORLANDO AVE | WINTER PARK | FL | 327894870 | |
| 1821081985 | LAGATTA | MARK | A. | 807 S ORLANDO AVE | WINTER PARK | FL | 327894870 |