# OSCEOLA OB-GYN PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609911825
- **Authorized official:** MICHAEL R DENARDIS DO (DO)
- **Authorized official phone:** (407) 518-1074

## Contact information

- **Practice address:** 1160 CYPRESS GLEN CIR, KISSIMMEE, FL 34741-7560
- **Practice address phone:** (407) 518-1074
- **Practice address fax:** (407) 518-9056
- **Mailing address:** 1160 CYPRESS GLEN CIR, KISSIMMEE, FL 34741-7560
- **Mailing address phone:** (407) 518-1074
- **Mailing address fax:** (407) 518-9056

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/21/2007
- **Last updated:** 02/18/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004198400 | — | FL |