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Organization
ADVENTIST HEALTH SYSTEMS SUNBELT INC
Active
Organization
ADVENTIST HEALTH SYSTEMS SUNBELT INC
Active
Other names
Loch Haven OB/GYN
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARYL TOL (PRESIDENT/CED)
(407) 303-1531
Entity
Organization
Contact information
Practice address
235 E. PRINCETON ST, SUITE 200, ORLANDO, FL 32804
(407) 303-1444
(407) 303-1446
Mailing address
235 E.PRINCETON ST, SUITE 200, ORLANDO, FL 32804
(407) 303-1444
(407) 303-1446
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010129012
—
FL
01
—
0476716
AETNA HMO EPO
FL
01
—
4578757
AETNA PPO
FL
01
—
97809
BLUE CROSS
FL
01
—
CB 1994
MEDICARE RAILROAD
FL
Enumeration date
10/02/2006
Last updated
12/30/2015
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